This episode features an interview with Doug Ramsthel and Jaclyn Rielly of Burnham Benefits. Doug serves as the Executive Vice President and Partner of Employee Benefits, and Jaclyn is the Vice President of the Irvine Office.
In this episode, Sasha, Doug, and Jaclyn discuss how the shift in pharmacy is affecting employers and members, the rising trend of GLP-1s, and why covering gene therapy drugs is important.
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“If I can convert somebody from a drug where I'm getting a $382 rebate to a cheaper drug where my net cost is a lot lower, that's a better benefit strategy. The only way to do that, in my opinion, is to take control as an employer. Self-fund and be able to start hitting these control buttons that will customize the plan, so you're focusing on the right things. Whereas the PBMs could be focusing just on their rebates because they're getting a slice of it. That's how they make their money.” – Doug Ramsthel
“Employers are really starting to get creative when it comes to managing their drug spend, and they have to, while focusing on different financial factors, as well as member behavior, when it comes to controlling costs. As plan costs for prescription drugs increase, member costs typically follow suit, whether it be through increases in cost sharing or premium contributions. With over 70% of office visits and hospital visits involving drug therapy, the rising costs of pharmacy are becoming more and more visible at the member level. I think the biggest shift, though, in pharmacy affecting members today really is that of access and affordability.” – Jaclyn Rielly
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Episode Timestamps:
*(01:13): How the shift in pharmacy is affecting employers and members
*(16:18): Doug discusses his book and obesity treatments
*(19:46): Doug dives into GLP-1s
*(33:08): Jaclyn discusses gene therapy drugs
*(45:50): Jaclyn explains the value-based formulary idea
*(49:40): Final thoughts on gene therapy drugs and GLP-1s
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Links:
Connect with Jaclyn on LinkedIn
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