Neil Minkoff, MD, Explains the Impact Formulary Has on Employer and Consumer Choice in the Health Insurance Exchanges

Neil Minkoff, MD, CEO, FountainHead HealthCare, discusses the impact that formulary has on both employer and consumer choice in the health insurance exchanges. He says that the industry has reached a point where an estimated 75% to 80% of prescription drug volume is generic. However, there’s less scrutiny of pharmacy benefits in general, as that scrutiny has moved to biotech and specialty.

“The employer and the plan are in a position of needing to offer the appropriate drug to the appropriate patient because it’s become the standard of care, but not being so generous in a benefit that they suffer from adverse selection… and that’s the tight rope that both employers and plans are trying to deal with right now,” he says.