Comparing The “Buy And Bill” Model VS The Pharmacy Benefit

How a specialty drug ultimately reaches the patient—and how it is paid for by that patient’s insurance—varies considerably depending on how it is reimbursed.

Currently, there are two main ways that a specialty drug can be reimbursed as it flows through the supply chain:

• As a medical benefit through the “buy-and-bill” model
• Or as a pharmacy benefit

But there’s a lot more to know about these models and thorough specialty drug sales training is beneficial.

To help sales professionals understand the different models—and their implications for their valued specialist customers—CMR Institute has developed a new training course Understanding Buy and Bill.

This engaging eLearning course was developed to complement your sales team’s knowledge and proficiency in specialty drug sales. Specifically, the buy-and-bill training course can help your sales team answer questions such as:

• What are the differences between the medical benefit (buy and bill) and the pharmacy benefit?
• What is the role of providers, distributors, and specialty pharmacies in each type of reimbursement and distribution model?
• What is “white bagging” and “brown bagging”? How do these workarounds allow payers to reimburse specialty drugs under the pharmacy benefit rather than through the buy-and-bill model?
• Which providers are most likely to find success with buy and bill?
• Under which type of model are payers more likely to use prior authorization and other strategies to manage the cost of specialty drugs?

Contact us to learn about this course and our other Specialty Drugs sales training courses covering:

• An Introduction to Specialty Drugs
• Specialty Drugs: Stakeholders and Market Trends
• Specialty Drugs: Distribution and Reimbursement
• The Dynamics of the Specialty Supply Chain
• The Cost of Specialty Drugs