The History, Philosophy, and Principles of Pharmacy Benefits

Abstract

OBJECTIVE: To provide an in-depth discussion of the philosophies, design, and structure of the prescription pharmacy benefit. DATA SOURCES: Benefit consultants, texts. CONCLUSION: Pharmacy benefits are structured using the same principles as other health care benefits. However, the design of benefits as wage alternatives complicates their implementation as employers insist upon performance and employees insist on receiving their benefits as entitlements. The resultant benefit designs are a balance between cost and risk management and provision of the services that beneficiaries expect.