Pharmaceutical Consulting - A Consumer's Guide

Although pharmaceutical consulting has existed forsome prescription medications. On occasion, these
only about 20 years, it has arguably shaped thefirms may even interact with doctors and directly
landscape of medical care in the U.S. more thaninfluence which drugs they prescribe, and under what
almost any other administrative function. Yetconditions.
surprisingly, few consumers are aware of theHow consumers can be better informed: Even if you
day-to-day decisions that firms make on their behalf.don't think your health-care insurer is limiting your
Here's a behind-the-scenes consumer's guide toaccess to certain medications, it's still a good idea to
pharmaceutical consulting.call your health plan's customer service number and
What it is: Pharmaceutical consulting is a processinquire about their "fomulary restrictions." Some
through which specialized firms help companies andinsurers deny all "out-of-formulary" medications, for
health-care providers reduce the cost of prescriptioninstance, while others allow them with an added
medication. The methods vary widely, from limitingsurcharge.
the types of medications that are covered byKnowing your insurer's rules-and to what extent
insurers, to analyzing administrative processes andthey're influenced by pharmaceutical consulting
recommending improvements in efficiency.firms-can help you be a more informed consumer. By
Why consumers should care: Consulting firms can helparming yourself with some knowledge about your
reduce the cost of prescriptions, which may translateprescription benefits, you'll be able to be a better
into slightly lower health-insurance premiums foradvocate for yourself, if you ever are denied access
consumers. But in some cases, firms may also maketo a prescribed medication down the road.
recommendations that reduce consumers' access to