You are here
An Overview of the Current Prescription Benefits Landscape
F. Randy Vogenberg has over 30 years of experience with drug benefit design, which will clearly be apparent to readers of his single-author text, Pharmacy Benefits. In 10 chapters and a total of 180 pages, the author provides a concise review of the evolution of the drug benefit design and a focus on its current state. The book is written at a level that will enable newcomers to the subject to quickly grasp the methods of benefit design while providing those actively involved in the field with important points for consideration. References at the end of each chapter, as well as a glossary, a list of commonly used acronyms, and an index, are included.
Nine of the 10 chapters deal directly with issues surrounding the development and management of a pharmacy benefit, and one chapter provides an overview of several public sector and government programs that provide a prescription drug benefit: Medicare, Medicaid, Children’s Health Insurance Program (CHIP), and Worker’s Compensation. While the author does not explicitly state the intended audience, it appears that the text would be suitable as a textbook for pharmacy management students as well as a useful guide for employee benefit managers.
Topics include pharmacy benefit management, plan design, practice guidelines, outcomes research, e-prescribing, formularies, drug utilization review, patient and provider compliance, pharmacy networks, and the selection and evaluation of a pharmacy benefit manager. Each chapter is complete with a bibliography for interested readers to seek out additional detailed information on the topic covered.
Effective use is made of tabular material and sidebar discussions to reinforce important points. For example, in the chapter on formularies, the author provides a plan sponsor with a number of questions, such as: Are there rebate agreements or other incentive contracts with manufacturers? What is the agreement based on? What are the potential savings to the plan? How much is shared with the payer? Future issues, including medication therapy management, generic biologics, and the impact of personalized medicine are all adequately covered.
The author is to be commended for delivering a text that provides a complete yet succinct overview of the salient issues to consider in the development and management of a prescription drug benefit. I highly recommend this book.