#172 - Pharmacy Policy Shifts: Winning Strategies for Healthcare

In this special RxBenefits-sponsored episode of The ASHHRA Podcast, hosts Bo Brabo and Luke Carignan explore the dynamic pharmacy benefits landscape with experts Sarah Hearn and Wes Hill (Director of Compliance & Legal Operations). Amid the busiest legislative season yet—over 1,500 bills—they discuss PBM reforms, ERISA challenges, compounding alternatives for GLP-1 drugs like Ozempic, 340B pricing, and emerging lawsuits. Gain insights on transparency, cost savings, and compliance for healthcare HR pros navigating employee benefits.

Key takeaways for healthcare HR leaders:

• Legislative Surge: 1,500+ state bills target PBMs, carriers, and more; expect increased reporting burdens but better data for informed decisions.
• ERISA Erosion Risks: States challenge federal uniformity—multi-state plans face conflicting laws; monitor for compliance headaches.
• Positive Reforms: New mandates empower plan sponsors with PBM data; leverage 340B and coupons to cut costs (e.g., Wegovy from $1,000 to $100/month).
• Compounding & Innovation: Affordable GLP-1 alternatives via telehealth, but ensure safety and avoid controlled substance pitfalls.
• Lawsuits to Watch: Oklahoma ERISA win; Arkansas PBM permit ban challenges interstate commerce—outcomes could reshape operations.
• Action Steps: Demand vendor transparency; align with ERISA; educate teams on benefits to prevent misuse and optimize savings.

Essential listening for HR managing rising pharmacy costs and regulations. Spark curiosity—reach out to RxBenefits for guidance!