Working for PBMs?

[Rutgers2015]

Okay so I took the career assessment on the APhA site and one of the matches I got was PBM. While there was a lot of info there, I wanted to ask you all about what pharmacists who work for PBMs do exactly? Also, do you think it would be valuable to have an MBA if I wanted to work for a PBM after I graduate? I noticed from their data that many of their pharmacists have advanced degrees above and beyond the Pharm D degree. Finally, the info packet indicated that opportunities for part time in this field is pretty limited. This is a concern for me down the line when I get married and have kids and such, so I was wondering if you knew anything about PBMs and part time as well.

Thank you all and have a wonderful day!

---

Members don't see this ad.

 

[lorain]

need a residency or related work experience to get into that field, a secondary degree will help you move up once you are in

 

[Rutgers2015]

What kind of residensy: managed care or drug info? (i'm assuming you mean PGY2 residency). Also, the reason I mentioned the MBA is that my school offers a program where you can stay an extra year after the completion of the PharmD degree and get an MBA (1 year full-time, 3 years part time) so I figured it's be easier to get that right away, unless i was able to do the part time program along with a residency, but i'd imagine that'd be very difficult.

Also, would it be possible to get relevant work experience while i'm still in school? how would i go about getting some?

Finally, as ideas as to the part-time part of my question?

Thanks!!!

 

[confettiflyer]

Okay so I took the career assessment on the APhA site and one of the matches I got was PBM. While there was a lot of info there, I wanted to ask you all about what pharmacists who work for PBMs do exactly? Also, do you think it would be valuable to have an MBA if I wanted to work for a PBM after I graduate? I noticed from their data that many of their pharmacists have advanced degrees above and beyond the Pharm D degree. Finally, the info packet indicated that opportunities for part time in this field is pretty limited. This is a concern for me down the line when I get married and have kids and such, so I was wondering if you knew anything about PBMs and part time as well.

Thank you all and have a wonderful day!

I was in the PA department at a PBM and many of their pharmacists work remotely some/most of the time. The only reason mine didn't was because he said his "personal hygiene and social skills would tank."

It's pretty much an 8-5 deal with no weekends/holidays. Go for a managed care residency (or at least a rotation), it's a lot of DI/lit eval stuff (ie AMCP dossier). Some places will hire straight out, but get at least an IPPE/APPE block there to network/get some face time.

Interesting field, but too slow for my tastes (maybe later as life circumstances change). Great if you want practically zero patient interaction.

 

[Rutgers2015]

I was in the PA department at a PBM and many of their pharmacists work remotely some/most of the time. The only reason mine didn't was because he said his "personal hygiene and social skills would tank."

It's pretty much an 8-5 deal with no weekends/holidays. Go for a managed care residency (or at least a rotation), it's a lot of DI/lit eval stuff (ie AMCP dossier). Some places will hire straight out, but get at least an IPPE/APPE block there to network/get some face time.

Interesting field, but too slow for my tastes (maybe later as life circumstances change). Great if you want practically zero patient interaction.

Thanks for your response! So I guess part time is possible? And the hours and compensation are what grabbed my interest to be honest, but I want to know if you could tell me exactly what kinds of tasks pharmacists are responsible for in these settings? Thanks again!

 

[confettiflyer]

Thanks for your response! So I guess part time is possible? And the hours and compensation are what grabbed my interest to be honest, but I want to know if you could tell me exactly what kinds of tasks pharmacists are responsible for in these settings? Thanks again!

Oh sure, here's what I gathered. The PBM I worked for had 2 primary areas for pharmacists: formulary/DUR and prior authorization (PA).

PA
Should be easy to figure out if you've worked retail. They sit at a computer and receive faxed requests from physicians (the technicians input all the data into the computer system). They review it and compare it to the PA guidelines and use some clinical judgment in determining if it's covered or not. Sometimes, they'll call the practitioner for additional info, or they'll take an incoming call from a practitioner who wants to argue their case....in that case, they can be escalated up to the physician in-house to have a peer-to-peer discussion.

My comments: it's kind of boring IMO, and this is the dept where people can work from home. Great if you're cool with doing repetitive stuff and limiting your interactions to a few coworkers & an occasional physician call.

Formulary/DUR
These guys do all the traditional PBM work. They'll get monthly/quarterly reports of utilization/usage for a given line of business. Their job is to identify the highest cost items and see if there are ways to mitigate those costs. Also, they identify trends in utilization and drug costs and will go about making changes to formularies to minimize costs to their client.

Example: colchicine went brand-only last year (ColCrys) due to some stupid FDA ruling and went from pennies per pill to dollars. the pharmacists investigated current practice guidelines to see if they could limit use of colchicine and use other agents. One idea was that colchicine wasn't really the best thing to be on long-term (it's more for flares), so you could put a 3 month limit on coverage and require a PA for longer use, that way you can push people to allopurinol or other UA lowering agents.

(this example is for illustration purposes only, i probably screwed up details)

They'll also monitor for new drugs in the pipeline, things that will go generic, things going up and down in price, and evaluate literature and pharmacoeconomic data to see if drug A is a better value than drug B even if it's more expensive.

Nutshell: Company gives PBM $10M and tells them "hey, PBM people, come up with a way to cover my 500 employees" so the PBM's job is to basically provide the highest/best coverage given the cost constraint (ie ration).

 

[owlegrad]

Nutshell: Company gives PBM $10M and tells them "hey, PBM people, come up with a way to cover my 500 employees" so the PBM's job is to basically provide the highest/best coverage given the cost constraint (ie ration).

You had me until that. The free market does not ration, sir.



j/k! Its just a joke people.

 

[kvl1027]

Okay so I took the career assessment on the APhA site and one of the matches I got was PBM. While there was a lot of info there, I wanted to ask you all about what pharmacists who work for PBMs do exactly? Also, do you think it would be valuable to have an MBA if I wanted to work for a PBM after I graduate? I noticed from their data that many of their pharmacists have advanced degrees above and beyond the Pharm D degree. Finally, the info packet indicated that opportunities for part time in this field is pretty limited. This is a concern for me down the line when I get married and have kids and such, so I was wondering if you knew anything about PBMs and part time as well.

Thank you all and have a wonderful day!

I did my Drug Information rotation at Curascript, a mail order pharmacy for Express Scripts. My rotation was in the PA department. All I can say is why would someone go to pharmacy college so they can grant PA's all day. It really is not that "pharmacy" related. I don't know why they would need a pharmacist to do that job. All I can say is snooze-fest.

Everyone is different, what I like others don't like and vice versa. Sitting in a cube all day was not for me. I will say the hours were desirable M-F 9-5, good benefits I'm sure, just really boring.

My advice to you would be to try and find a rotation at a PBM so you can find out first hand whether or not you would like it. Or just try to find someone you can shadow.

 

[Rutgers2015]

Thanks for the info! I guess the best thing to do would be to do a relevant rotation...

I have another related (sort of) question: What are the hours like in a pgy1 general residency and a managed care reseidency? More specifically, do you think I could be a part time graduate student at the same time (in the evenings?) The reason I ask is because if i decide i want to go into this area of pharmacy, i would need a residency (2years) as well as an MBA. my school has a program in which i could get my mba full time 1 year after graduation or part time in 3 years after graduation. Do you think i could work on my mba while doing my residency?

thoughts??

 

[lorain]

Thanks for the info! I guess the best thing to do would be to do a relevant rotation...

I have another related (sort of) question: What are the hours like in a pgy1 general residency and a managed care reseidency? More specifically, do you think I could be a part time graduate student at the same time (in the evenings?) The reason I ask is because if i decide i want to go into this area of pharmacy, i would need a residency (2years) as well as an MBA. my school has a program in which i could get my mba full time 1 year after graduation or part time in 3 years after graduation. Do you think i could work on my mba while doing my residency?

thoughts??

one at a time...or else its just overload....residencies all vary on time commitment, nothing standard

 

[confettiflyer]

most are 8-5 M-F, PBM's are pretty much like any random office. There are random evening meetings or conferences on weekends, but it generally keeps banker's hours.

Difference might be if you're on the PA department and one of your lines of businesses are in a different time zone, but that will depend on a lot of things.

Every consider medical information for industry? Lot of the same elements involved with PBM's (and lifestyle)

 

[Tinkerbell22]

hypothetical two part question:

if you wanted to do a PGY2 residency, would it be beneficial to apply to a PGY1 residency at the location of the PGY2 residency you are interested in? (is this how it even works??? sorry, i have a couple years to get to that point)

if you wanted to wait until rotations to get experience in an area like PBM... would it be too late to apply for residencies afterwards? ie: would you be applying for residencies before you get through most of your rotations (like in the fall?)

I know I could research this, but I thought I'd be lazy and ask anyway since it might help someone.

 

[confettiflyer]

hypothetical two part question:

if you wanted to do a PGY2 residency, would it be beneficial to apply to a PGY1 residency at the location of the PGY2 residency you are interested in? (is this how it even works??? sorry, i have a couple years to get to that point)

It would help in the same way that an intern has an easier chance of getting a job at the place he/she interned at. You'd have the "inside track" and residency will essentially be a 7-8 month long interview.

Downside is... the place gets to see your flaws & personality quirks in addition to your strengths.

if you wanted to wait until rotations to get experience in an area like PBM... would it be too late to apply for residencies afterwards? ie: would you be applying for residencies before you get through most of your rotations (like in the fall?)

I stacked all my important rotations to happen before ASHP Mid-Year (2 crit care, industry, etc...). This is generally the way to go and hopefully your school lets you pick individual sites like my school. Applications are typically turned in around December (varies, i've seen them into early january) so if you plan your schedule correctly, you should be able to experience an area before applying.

 

[Rutgers2015]

Confettiflyer, I just reread through this whole thread and I can't even begin to describe how grateful I am to you for all the information you have given me! It's superb! Thank you sosososososoosososososooso much and a thank you also to everyone else who took the time to post in this thread.

I have a few more questions:

Every consider medical information for industry? Lot of the same elements involved with PBM's (and lifestyle)

Tell me about this field please. I haven't heard much about it at all.

Also, you mentioned it's possible to work for a PBM straight out of school (as in, with no residency). How common is this? Would I be at a disadvantage in terms of salary, position, knowledge, etc if I was a "fresh hire?" Is the only way to this to have a really good managed care advanced rotation? (or internship I guess) How easy is it to get a job as a pharmacy student in one of these companies in today's economy? Do they even offer students jobs? Or only internships? Also, do you think they'd pay for me getting my MBA (as a company) if I decided to, or should I just do it on my own expense when I am able?

And a question for you: You're going into your final year of pharmacy student from the way it sounds (or you've just graduated, in which case, Congrats!!). What area of pharmacy are you looking to enter and what are your plans post-graduation? I'm only going to be a P1 this fall so I still have plenty of time to think about all this, do my research, get good grades, and get experience (I've been working retail at CVS for a year now-- almost certain I would dread working there as a pharmacist though lol). Any advice for me?

Thank again everyone!!!

 

[confettiflyer]

Tell me about this field please. I haven't heard much about it at all.

Also, you mentioned it's possible to work for a PBM straight out of school (as in, with no residency). How common is this? Would I be at a disadvantage in terms of salary, position, knowledge, etc if I was a "fresh hire?" Is the only way to this to have a really good managed care advanced rotation? (or internship I guess) How easy is it to get a job as a pharmacy student in one of these companies in today's economy? Do they even offer students jobs? Or only internships? Also, do you think they'd pay for me getting my MBA (as a company) if I decided to, or should I just do it on my own expense when I am able?

And a question for you: You're going into your final year of pharmacy student from the way it sounds (or you've just graduated, in which case, Congrats!!). What area of pharmacy are you looking to enter and what are your plans post-graduation? I'm only going to be a P1 this fall so I still have plenty of time to think about all this, do my research, get good grades, and get experience (I've been working retail at CVS for a year now-- almost certain I would dread working there as a pharmacist though lol). Any advice for me?

Thank again everyone!!!

No problemo...not many people know about PBM's, I'm probably one of the few that have rotated into that on SDN (if you're out there...hellooo).

Medical Information within the industry is basically like the drug information arm of a pharmaceutical company. Everytime a brand drug is marketed/released, there's a whole team behind it that supports it--everyone from drug reps to people doing post-marketing surveillance, etc... One of those support functions is medical information -- anytime a rep can't answer a question (either it's too clinically deep or not a labeled indication,) they have to escalate it up. OR if a practitioner initiates a question about a new study for a drug and wants some more information. There's other functions too (like helping train other staff in new drugs, etc...).

You being at Rutgers...you are smack in the middle of industry, I'm sure you'll have opportunities to rotate into a pharm company at some point. If you can, do it just to see.

Okay your 1st set of questions about getting hired and/or internships -- I can't really answer, it all depends on the company. Like any place to work, it would be difficult to get a job without knowing anyone there. If you rotate in, that serves as a de facto interview/trial period and I've seen this happen many places (including PBM's). Once you're hired, no matter if you are "fresh," rotated in, or were a resident there/somewhere else.... you wouldn't be at a disadvantage knowledge-wise (for long, anyway). It might take you an extra week or two to learn the computer systems, workflow, and culture, but really the hard part is getting hired in the first place...so work on your networking & maximize your experiences/face-to-face contact.

2nd set of questions -- I'm in rotations now, so I won't graduate until 2012. My advice for you is to try to find a hospital internship job unless you're 100% sure you want to work at CVS. They'll probably jettison you anyway if you don't sign a contract with them later on. Retail intern jobs, IMO, are only good if you're planning to be retail-for-life. Hospital jobs look a little sexier on your CV and open you up to more/wider opportunities later on, ESPECIALLY if you're wanting to work in a non-retail environment where many of pharmacists either hated/escaped retail or have some sort of disdain (YMMV -- some pharmacists love retail, so try not to trash talk too much).

Other advice -- get involved, but not too involved, with organizations... and try to do some research/present some posters at ASHP.

My background, if you had other questions: CVS for 1yr pre-pharmacy, 2 years inpatient intern, 2 posters, minimal org involvement, undecided on pursuing residency/career path...except no to retail

 

[Tinkerbell22]

It would help in the same way that an intern has an easier chance of getting a job at the place he/she interned at. You'd have the "inside track" and residency will essentially be a 7-8 month long interview.

Downside is... the place gets to see your flaws & personality quirks in addition to your strengths.

I stacked all my important rotations to happen before ASHP Mid-Year (2 crit care, industry, etc...). This is generally the way to go and hopefully your school lets you pick individual sites like my school. Applications are typically turned in around December (varies, i've seen them into early january) so if you plan your schedule correctly, you should be able to experience an area before applying.

thanks for the info! i think the rotation selection at our school is through a ranking process. i'm not sure if it would be best to do the advanced clinical track though, because i'm pretty sure all of the rotations are at the same site, and i doubt i would be able to get experience somewhere like a PBM.

how many LORs did you have to get for your applications?

My advice for you is to try to find a hospital internship job unless you're 100% sure you want to work at CVS. They'll probably jettison you anyway if you don't sign a contract with them later on.

oh they will... seen it done.

 

[confettiflyer]

thanks for the info! i think the rotation selection at our school is through a ranking process. i'm not sure if it would be best to do the advanced clinical track though, because i'm pretty sure all of the rotations are at the same site, and i doubt i would be able to get experience somewhere like a PBM.

how many LORs did you have to get for your applications?

Oh sorry I probably hid it in another post, but I just started rotation/APPE year last month. I'm culling from my own scheduling & rationale + friends' advice, so no LORs under the belt yet, but I have a solid 3 I will ask as of right now.

 

[Rutgers2015]

No problemo...not many people know about PBM's, I'm probably one of the few that have rotated into that on SDN (if you're out there...hellooo).

Medical Information within the industry is basically like the drug information arm of a pharmaceutical company. Everytime a brand drug is marketed/released, there's a whole team behind it that supports it--everyone from drug reps to people doing post-marketing surveillance, etc... One of those support functions is medical information -- anytime a rep can't answer a question (either it's too clinically deep or not a labeled indication,) they have to escalate it up. OR if a practitioner initiates a question about a new study for a drug and wants some more information. There's other functions too (like helping train other staff in new drugs, etc...).

You being at Rutgers...you are smack in the middle of industry, I'm sure you'll have opportunities to rotate into a pharm company at some point. If you can, do it just to see.

Okay your 1st set of questions about getting hired and/or internships -- I can't really answer, it all depends on the company. Like any place to work, it would be difficult to get a job without knowing anyone there. If you rotate in, that serves as a de facto interview/trial period and I've seen this happen many places (including PBM's). Once you're hired, no matter if you are "fresh," rotated in, or were a resident there/somewhere else.... you wouldn't be at a disadvantage knowledge-wise (for long, anyway). It might take you an extra week or two to learn the computer systems, workflow, and culture, but really the hard part is getting hired in the first place...so work on your networking & maximize your experiences/face-to-face contact.

2nd set of questions -- I'm in rotations now, so I won't graduate until 2012. My advice for you is to try to find a hospital internship job unless you're 100% sure you want to work at CVS. They'll probably jettison you anyway if you don't sign a contract with them later on. Retail intern jobs, IMO, are only good if you're planning to be retail-for-life. Hospital jobs look a little sexier on your CV and open you up to more/wider opportunities later on, ESPECIALLY if you're wanting to work in a non-retail environment where many of pharmacists either hated/escaped retail or have some sort of disdain (YMMV -- some pharmacists love retail, so try not to trash talk too much).

Other advice -- get involved, but not too involved, with organizations... and try to do some research/present some posters at ASHP.

My background, if you had other questions: CVS for 1yr pre-pharmacy, 2 years inpatient intern, 2 posters, minimal org involvement, undecided on pursuing residency/career path...except no to retail

Yea I'll consider a rotation in industry, we've got plenty in NJ! As for my work, to be honest, it's good because I actually don't have a car and CVS is the only pharmacy close enough to walk to, or be easily driven to. That in mind, I'd have to say it has taught me a lot. It's really hard to get a job in a hospital with absolutely no pharmacy technician training or experience. Plus, it's introduced me to how to bill insurance, what a PA is, and lots of meds, their generics, their uses, etc. Plus, I love the employee discount . I'm hoping to have a car by next summer right before my first IPPE, so I guess that limits me to working at CVS for another year, since I cant commute to a hospital? Unless I try to work at a hospital by Rutgers during the semester, but that might be too hectic with the courseload (I'm taking 19 credits and it's my first semester of real pharmacy lol! ). Best of luck to you though and I'll definitely be posting here or messaging you if/when I have more questions if that's alright with you.