What kind of work do they do? Is a residency required? What's the pay? Any other related information would be very appreciated.
Pharmacists working for Prescription Benefits Manager?
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konkan said:
Working for a phamacy benefits manager (i.e. PBM) typically do require 1yr of pharmacy residency training. Some may also require some yrs of practice as a clinician after competing residency training. The practice portion tends to vary, but the main focus the PBM is looking for is that you have worked in a managed care environment previously.
What kind of work do they do...Evaluating the literature and streamlining the various drug formularies to what is most cost effective. Examples like having one non-sedating antihistamine on formulary and then developing a "criteria for use" as a tool by which other antihistamines may be prescribed by the prescribers. This gets more complicated when dealing other health issues (i.e. neuropathic pain, mental illness, HTN, etc). In addition you may also be assigned to review new agents (i.e. drug monographs) and develop a criteria for use based on clinical trials, comparative analysis w/ other agents within the same class, and consider cost vs other agents in the class. The VA system, Kaiser, Caremark, and Walgreen Health Initiatives are probably some of the biggest PBMs. The PBM for the VA can be viewed online at www.pbm.va.gov. Basically working for a PBM is like being a clinical pharmacist in any other setting w/o having to cover for a particular pt unit or having any pt care responsibilities. Since you'd be working in an office setting you wouldn't have to worry about covering the CCU so you'd focus all of your time reviewing the literature and comparing various drug therapies. Upside...If you really enjoy literature searches, journal critiques, pharmacoeconomics then it can really be enjoyable. Downside is that you typically don't have any interaction w/ a pt and unless you had a lot of clinical "real world" experience previously than you aren't likely to see how the "real world" outcomes affect the general population as compared to if you worked in a hospital/retail setting. It just depends what you enjoy doing more.
Why is residency training typically required?...Well there are always exceptions, so you may potentially get a position w/ a PBM w/o residency training; however, your likelihood for moving up w/i the company w/o residency training or some management training or auxillary degree (i.e. MBA or MHA) may be less w/o some auxillary experience in a clinical or management arena. Secondly, residency training is supposed to further develop the individual's ability to evaluate the literature and determine a role for the agent in clinical practice. Residency training typically helps develop the pharmacist in this regard and also helps much more w/ the "real world" application of the certain regimens in everyday life.
Salary...well it varies, but would be consistent w/ everything you see in pharmacy so it will vary w/ geographic region. Avg given geographic variance is probably ~90k-100k for clinical pharmacists, w/ directors and/or middle management doing ~100-120k/yr.
To expand a bit on Kwizard's excellent review of this field.....Medicaid & probably most of the new Medicare related insurers will have this type of individual as well.
In CA - our Medicaid is not uniform statewide. Altho there is a state plan (which has a staff of phamacists devoted to evaluating formulary changes), most of our large counties have their own plans with different formularies from the state plan. When a county has its own plan, that is the dominant formulary. The Medicare plans...who knows...there might be one pharmacist - not too many I think since the drug choices don't seem too rational...but its still early - we'll have to wait & see on these.
Additionally, this same type of individual also works in acute health settings. At large multi-hospital health care consortiums, there is a staff of pharmacists who evaluate and make formulary recommendations. On a smaller scale...every hospital has a P&T committee, which is usually chaired by the Director of Pharmacy but also has a practicing pharmacist as a permanent member.
In CA - our Medicaid is not uniform statewide. Altho there is a state plan (which has a staff of phamacists devoted to evaluating formulary changes), most of our large counties have their own plans with different formularies from the state plan. When a county has its own plan, that is the dominant formulary. The Medicare plans...who knows...there might be one pharmacist - not too many I think since the drug choices don't seem too rational...but its still early - we'll have to wait & see on these.
Additionally, this same type of individual also works in acute health settings. At large multi-hospital health care consortiums, there is a staff of pharmacists who evaluate and make formulary recommendations. On a smaller scale...every hospital has a P&T committee, which is usually chaired by the Director of Pharmacy but also has a practicing pharmacist as a permanent member.
