Chapter 8: Pharmacy Benefit Management

Question 1

Pharmacy benefit management refers to?

Answer 1

A third-party administrator that handles prescription medication claims for insurance companies and government benefit programs.

Question 2

A Pharmacy benefit manager (PBM) acts as an intermediary between the drug manufactures and insures with the goal to?

Answer 2

Reduce the amount that insurers and patients spend on prescription medications.

Question 3

What is the first measure in which Pharmacy benefit management accomplished this goal?

Answer 3

Maintaining a network of participating pharmacies.

Question 4

What is the second measure in which Pharmacy benefit management accomplished this goal?

Answer 4

Processing prescription claims.

Question 5

What is the third measure in which Pharmacy benefit management accomplished this goal?

Answer 5

Negotiating drug prices.

Question 6

What is the fourth measure in which Pharmacy benefit management accomplished this goal?

Answer 6

Developing formularies of medications that are approved for reimbursement.

Question 7

What is the fifth measure in which Pharmacy benefit management accomplished this goal?

Answer 7

Managing patient’s access to specialty medications.