Optimizing Pharmacy Benefits in Value-Based Care: A Conversation with Dan Mendelson

In Episode 435 of 'Relentless Health Value,' Stacey Richter hosts Dan Mendelson from Morgan Health to discuss the importance of integrating pharmacy benefits into the broader context of value-based care. The conversation stems from a LinkedIn post by Mendelson outlining five key considerations for optimizing pharmacy benefits. Topics include the total cost of care, the need for value-based decision-making in pharmacy benefits, the integration of clinical teams in formulary development, and the critical role of patient engagement. The episode also explores how employers can better manage healthcare costs by aligning incentives and navigating the complexities of the pharmaceutical landscape. Key advice for various healthcare stakeholders, including pharma companies, hospitals, and primary care doctors, is also provided.

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00:00 Introduction

00:28 The Intersection of Pharmacy Benefits and Value-Based Care

00:57 The Critical Role of Pharmacy in Healthcare Outcomes

03:16 Exploring Pharmacy Benefits Optimization with Dan Mendelson

03:39 Morgan Health's Mission and Healthcare Innovation

04:46 The Conversation with Dan Mendelson: Deep Dive into Pharmacy Benefits

06:13 Strategies for Optimizing Pharmacy Benefits in Value-Based Care

11:19 The Future of Pharmacy Benefits and Employer Concerns

12:40 Advice for Pharma Companies in a Value-Based Healthcare System

16:13 Innovative Approaches to Managing Pharmacy Benefits

16:56 Engaging Patients in Pharmacy Benefit Decisions

18:06 Experimental Drug Tiers and Formulary Design

21:49 The Importance of Value-Based Contracting for Pharma

31:23 Lightning Round: Advice for Various Healthcare Stakeholders

34:47 Closing Thoughts and Invitation to Engage Further