Brian Anderson of Milliman Focuses on Making Pharmacy Benefits Work Better for Patients | PBMI Innovator

Brian Anderson, MBA, a principal and consulting actuary at Milliman, is one of the inaugural winners of Managed Healthcare Executive’s PBMI Innovator Award. The award honors leaders who are reimagining how pharmacy benefits are delivered and helping the system evolve despite growing leaps and hurdles.

Anderson’s work lies at the forefront of data, strategy and patient experience. In an interview with MHE editors, he shared his entry into the pharmacy benefits space was driven by a desire to improve healthcare by making it easier for people to access what they need—especially medications.

The core of Anderson’s approach is a focus on the patient journey. He said while most pharmacy interactions are smooth, the industry often focuses too much on the exceptions rather than the norm.

“If we look at our data, by far, well over 90% of every single interaction at the pharmacy is somewhat seamless—someone goes in, they get their medication, they come back out (at) a very affordable price,” he said. “In fact, today, the average one-month out-of-pocket cost for a medication, for at least the numbers we get to help support, is less than $8, and that kind of experience happens a lot. But I also appreciate that there’s the smaller percent where something doesn’t quite go right, the cost is higher than expected, maybe there's a prior authorization or something like that that has to be addressed.”

Anderson added that he wants to see folks in his role turn those moments that don’t go right into a process that’s “easier and more seamless” for the member, the pharmacy and the provider too. He also noted that simplifying the experience is just as important as maintaining the affordability and efficiency the majority of patients already enjoy.

In the conversation, he credited Caremark for its investments in patient-first innovation and said there’s more to be done to ensure pharmacy benefit managers (PBMs) continue to focus on both patient experience and cost containment. As the pharmacy landscape continues to shift, Anderson shared he hopes to keep pushing for systems that put patients first while managing costs effectively.