Don Anderson, Pharm.D., on closing the prescription data gap | PBMI 2026

Closing the visibility gap created by fragmented pharmacy purchasing could begin with some immediate steps but the ultimate solution may need a longer-term regulatory change, according to Don Anderson, Pharm.D., vice president of OrionRx, a pharmacy benefit manager headquartered in Irvine, California.

In an interview with Managed Healthcare Executive last week at the 2026 Pharmacy Benefit Management Institute Annual National Conference in Orlando, Florida, Anderson said health plans and pharmacy benefit managers (PBMs) need patients to share information about the medication they’re taking outside those covered by the pharmacy benefit. The longer-term solution, he said, will likely require regulation mandating that any entity dispensing medication transmit data about that drug fill so PBMs would have some broader visibility into the drugs that someone is taking. Such regulation is still years away, he said, even as problems arising from the current gap are already occurring.

To get members to disclose what they’re taking, Anderson mentioned a “carrot and stick” approaches. He mentioned flexible spending cards as one way of capturing data even if it lacks the detail of claims data.

“It probably won't give you the level of specificity that I would get on a claim today, which is fine,” Anderson said. “It's at least something over what I have, you know, currently, which is nothing.”

Anderson spoke with MHE after participating in PBMI panel titled “Direct-to-Consumer Models and the Safety Question No One Owns,” alongside Martty Martínez Fraticelli, Pharm.D., chief executive officer of PharmPix.