PBMs play role in personalizing medications for children
Pharmacy benefits managers are paying attention to medications that specifically target children
By Mari Edlin
Pharmacy benefits managers (PBMs) are paying attention to medications that specifically target children. Prime Therapeutics, a PBM in Eagan, Minnesota, considers all age groups when its pharmacy and therapeutics committee reviews drugs for formulary. For example, ethosuximide, a drug for seizures that has pediatric safety and effectiveness data, is included on formulary specifically for the pediatric population.
“Prime evaluates all drugs for an opportunity to improve the quality and safety of their use regardless of the age group for which they will be used,” says David Lassen, PharmD, chief clinical officer. “We follow scientific treatment guidelines and published clinical evidence to establish utilization management programs.”.
Similar to Prime, Express Scripts, a PBM based in St. Louis, builds its national formularies to serve large patient populations of all ages. “We have a pediatrician on the P&T Committee who helps assess new and existing medications and ensures that the needs of pediatrics and pediatricians are being met,” says Monique Parr, MD, director of clinical therapeutics.
“Pediatric dosing is incorporated into concurrent drug utilization programs used by Express Scripts,” she says. “We follow the drug labels and guidelines established by the FDA for pediatric dosing of drugs. In addition, safety programs such as RationalMed incorporate pediatric guidelines and age-based considerations.”
A Conversation With Greg Baker, RPh, CEO of AffirmedRx
March 31st 2024Greg Baker, CEO of AffirmedRx, describes his early career, shares some of his critical opinions about the pharmacy benefit management (PBM) industry and how, in his view, his company is offering a better alternative.
Read More
David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
Listen
Florida Gets the OK. But Will Drug Importation from Canada Actually Happen?
March 5th 2024Canadian health officials warn that maintaining a drug supply for Canadians is their priority. The staunch opposition of the U.S. pharmaceutical industry may also be an obstacle to imports from north of the border.
Read More
Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.
Listen
What Payers Need to Know As Retail Pharmacies Move Into Primary Care
September 6th 2023Healthcare beyond the doors of the doctor’s office has the potential to offer more care to more people. But payers need to think about how to ensure that care is consistent. Regardless of the setting, care decisions must be based on evidence-based content and supported with strong patient education.
Read More
