The following statements are about the inclusion of unified pharmacy benefits in health plan healthcare packages. Select the answer choice containing the correct statement.
A) When pharmacy benefits management is incorporated into an health plan's operations as a unified benefit, the health plan establishes pharmacy networks, but a pharmacy benefits management (PBM) company manages their operations.
B) Under a unified pharmacy benefit, an health plan cannot use mail-order services to provide drugs to its members.
C) Compared to programs that do not manage pharmacy benefits in-house, unified pharmacy benefits programs typically give health plans more control over patient access to prescription drugs.
D) Compared to programs that do not manage pharmacy benefits in-house, unified pharmacy benefits programs make drug therapy interventions for plan members more difficult.

Question

Quizplus · Accepted Answer

Unified pharmacy benefits programs typically give health plans more control over patient access to prescription drugs compared to programs that do not manage pharmacy benefits in-house. This is because pharmacy benefits management is incorporated into the health plan's operations, allowing for more streamlined and coordinated care. The health plan can negotiate pricing with pharmacies and PBMs, and can also set formularies and utilization management programs. These measures can help control costs and ensure appropriate use of prescription drugs by plan members. Option A is not entirely correct, as a PBM company may manage operations, but the health plan still has some level of control. Option B is incorrect, as health plans may still provide mail-order services under a unified pharmacy benefit. Option D is incorrect, as unified pharmacy benefits can actually make drug therapy interventions easier, since the health plan has more control and can implement various interventions (such as medication therapy management) to improve patient care.

The Following Statements Are About the Inclusion of Unified Pharmacy