FAQ: Your PBM is not enough…

Your PBM may not be giving you the best prices (because it’s not always in their best interest to do so).

In theory, Pharmaceutical Benefit Managers (PBMs) are are supposed to simplify things by dealing with claim transactions between pharmacies and health-plan sponsors, as well as use their size to negotiate pricing with drug makers and those same pharmacies. Unfortunately, that’s not the way it most often works.

Today, PBMs are more often both benefit administrator and provider, and most enjoy very close ties with drug manufacturers. Because of this, PBMs often end up disproportionately influencing health care decisions, in the interest of maximizing shareholder profits and often to the detriment of patients and plan sponsors.

PBMs often control prescription drug plan formularies and get rebates from the drug manufacturers for favoring certain brand-name drugs over others. These deals are often shrouded in secrecy, with PBMs frequently collecting payments without sharing information with health plan sponsors. Such profit incentives can actually result in higher-priced medications being recommended to customers.

Scriptas is a completely different kind of beast.

The recommendations provided by Scripta are based on physician input and actual drug costs, and are not driven by rebates or directed by internal profit margins. Our goal is to support the doctor-patient relationship and thereby to create a healthier, more productive workforce and a culture of cost containment that supports the plan sponsor’s business goals.


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© Copyright 2020 Scripta Insights, Inc. 

Scripta™ is neither a pharmacy nor a doctor. The benefit service does not tell you what drug to take and does not participate in the drug selection process. Only your physician can determine the medications that are right for you. These alternative medications are options for less costly drugs that physicians may prescribe in place of the medications you are taking now. Scripta has reviewed your current medications only for the purpose of identifying potential cost savings for you to consider with your physician. Scripta has not analyzed the effectiveness or other therapeutic aspects of these medication alternatives. Accordingly, this report and any other forms of communication received from Scripta are not, nor should they be interpreted as, any form of treatment, drug regimen review, or provision of counseling or consultation by a prescriber, pharmacist or pharmacy. Do not stop taking your medication, change your medication, or start taking a new medication without being directed to do so by your physician and filling the prescription under the oversight of a licensed pharmacist. The alternatives set forth above may not be equivalent to your current medication, may interact adversely with your other medications, may not be indicated in light of your other conditions, may cause different or severe side effects, or may be less effective at treating your condition. Medication prices are approximate based on information provided by your pharmacy benefits manager, insurance plans, and/or employer, and may vary from pharmacy to pharmacy. Check with your insurance plan to obtain a full list of pharmacies where your prescriptions can be filled. All information herein is HIPAA protected, treated as highly confidential, and never shared with your employer.

Scripta™, Scripta Insights™ and The Best Meds at the Best Price® are registered trademarks of Scripta Insights, Inc. The contents of the site are for informational purposes only and not intended as a substitute for professional medical advice, diagnosis, or treatment. We do not recommend or endorse any specific prescription drug or pharmacy that may be mentioned herein. Reliance on any information provided by us, our affiliates, employees or others is solely at your own risk.