“EP166: How to Optimize Pharmacy Spend With Tim Thomas of Crystal Clear Rx”
by Stacey Richter

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Americans spend a lot on prescription drugs, more per capita than any other country by far. Pharmacy spending used to be about 5% of total medical spend, but today it can be as high as 25%. Today I speak with Tim Thomas from Crystal Clear Rx about what we can do to ensure that we’re not overpaying for already pricey meds. As a case study, Tim talks about how Caterpillar is dealing with this trend.

Tim Thomas, RPh president, Crystal Clear Rx

Mr. Thomas is a graduate of the University of South Carolina College of Pharmacy, and has 38 years’ experience as a pharmacist. His management background includes residency training and being a Director of Pharmacy at both a hospital and an HMO.

For the last 25 years Mr. Thomas has been involved in managed care pharmacy with expertise in formulary, benefit design, and creating value in the pharmacy benefit. He developed a PBM in the 1990’s and has held senior positions within the PBM industry. In 2008 he created Crystal Clear Rx, a pharmacy benefit consulting and research firm that is singularly focused on helping clients realize better value from their pharmacy benefit by providing optics into the PBM contracting process, data analysis, and cost effective solutions.

00:00 The ongoing situation with pharmacy spend.
04:20 The increase in pharmacy spend.
06:45 Dissecting the specialty pharmacy cost.
08:20 The challenge of identifying specialty pharmacy costs.
10:30 Are pharmacy costs a good spend in overall health care costs?
13:40 Choosing the best PBM option for you.
17:23 What a direct contract with a pharmacy looks like.
19:30 Why an employer would hire a PBM.
21:30 The real problem behind, and some possible solutions for, formulary decisions.
23:15 Patient compliance vs cost.
24:10 Clinically-based, patient-based formulary vs rebate formulary.
28:45 Things that are improving patient engagement and consumerism.
29:15 How modern tech is helping improve pharmacy spend.
30:30 What Crystal Clear Rx does and how it engages with health systems.
32:00 You can learn more at www.crystalclearrx.com.

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