Written Communication From Pharmacy Benefit Managers: Is It Helpful?

Area of Science:

• Geriatric Medicine
• Health Services Research
• Clinical Pharmacy

Background:

• Physician burnout is exacerbated by administrative tasks, including excessive mailings from Pharmacy Benefit Managers (PBMs).
• The volume and utility of these communications to practicing physicians are not well-characterized.
• Understanding physician response to PBM communications is crucial for reducing administrative burden.

Purpose of the Study:

• To quantify the frequency of mailed communications from PBMs to a geriatrician.
• To determine the rate at which these communications result in physician intervention.
• To identify communication types most likely to prompt physician action.

Main Methods:

• Collected all written PBM communications to a single geriatric outpatient physician over 22 months (July 2021 - May 2023).
• Categorized communications by PBM, type, and whether they resulted in a physician intervention.
• Analyzed frequency of communications and intervention rates, including repeated mailings.

Main Results:

• Out of 263 total communications, only 17 (6%) led to physician interventions.
• Nonformulary prescription notices and drug-drug interaction alerts were the most frequent triggers for intervention (35% each).
• Beers list notifications and general recommendations did not typically result in physician action; 41% of communications were repeated.

Conclusions:

• The study supports the hypothesis that a small fraction of PBM mailings are helpful to physicians.
• Physician intervention is more probable for nonformulary or drug-drug interaction alerts.
• Reducing non-actionable mailings, such as Beers list notifications, could decrease physician paperwork and combat burnout.