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One of the most important contractual elements in a Pharmacy Benefit Manager’s (“PBM”) service agreement that is used in pharmacy benefit cost reduction is the definition¬† and utilization of the MAC (“Maximum Allowable Cost”) list.¬† The MAC generally refers to a PBM-generated list of products that includes the upper limit or maximum amount that a […]

As if these dire warnings should come as any surprise, insurers who are providing health insurance coverage in the public exchanges are sounding the alarm! WARNING: LOSSES UNDER OBAMACARE ARE UNSUSTAINABLE! Really? How could there be any other outcome? A completely overblown healthcare “crisis” was addressed through mandated coverage that had to be over-priced in […]

2016 will be a crazy year for PBMs and plan sponsors of pharmacy benefit programs. The cast of characters continues to shrink through market consolidation, and most analysts believe that the trend will continue. At Wilkinson Benefit Consultants (wbcbaltimore.com), we’ve listened to plan sponsors raise the questions of “Where do we turn?” and “How can […]