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Board hears PBM and specialty drug trends; members press for rebate transparency after out‑of‑pocket case
Summary
Aon and Dr. Neil Mills briefed the board on PBM mechanics, e‑prescribing, rising specialty drug spend and biosimilars; Aon cited about $6.2M in pharmacy rebates returned to SFHSS in 2018. Public commenter Erica Maybaum described a case where paying out of pocket cost less than using her benefit and asked whether reimbursement was possible.
Aon consultants and Dr. Neil Mills presented an overview of pharmacy benefit manager (PBM) mechanics, rebate flows, and emerging trends in specialty drugs and biosimilars.
Dr. Mills explained two parallel supply chains—drug supply and financial arrangements—and said PBMs act as intermediaries between manufacturers and pharmacies while rebates, formularies and step edits influence net cost. He described e‑prescribing as an emerging tool that can show clinicians member cost share in real…
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