True Benefit Integration Supports Your Employees’ Safety
For the best safety, make sure your Pharmacy Benefits Manager (PBM) includes rigorous safety programs and drug benefit management at no additional cost. If you don’t, you may find yourself paying for clinical programs, employee communications/outreach and more on top of your premium.
It’s important to measure a PBM by the overall health outcomes it produces for you and your employees. Following are two examples of how Excellus BlueCross BlueShield does that.
- A member with multiple sclerosis who was being treated with Tysabri® (a medication covered under the medical benefit) was also prescribed an immunosuppressant medication, azathioprine (covered under the pharmacy benefit), by a different physician for an unrelated disease. Because Excellus BCBS pharmacists monitor the medical and pharmacy claims systems simultaneously, checking for drug interactions across benefits, they captured what could have been a very serious drug interaction – one known to cause brain damage and potentially death. Because our pharmacist immediately reached out to the member’s physician, the Tysabri treatments were postponed, and the physician was thankful to be able to care for his patient.
- In response to an FDA warning regarding a possible drug interaction between select antidepressants and the breast cancer drug Tamoxifen, Excellus BCBS pharmacy management mailed communications to providers and members who were receiving the combination. After the mailing, 60% of members no longer had an identified interaction in their claims, and an oncologist sent a letter thanking Excellus BCBS for notifying him that his patient was receiving an interacting antidepressant from a different provider.
So, for the best outcomes, make sure your PBM has a vested interest in your employees and our community. As a local, non-profit organization, Excellus BlueCross BlueShield has this vested interest. Our offerings are designed to proactively manage your employees’ health and your costs to produce real results.