Why an Independent P&T Committee Matters for Your Pharmacy Program
When it comes to pharmacy benefits, the role of your pharmacy vendor is to ensure that patients receive safe, effective, and cost-efficient medications when they need them. But who has the responsibility of making sure that happens? This often falls to a specialized group called a Pharmacy and Therapeutics Committee, which is sometimes referred to as a P&T Committee. You may have heard this term, but who are they and why is their role important for your plan and members?
Understanding the Role of a Pharmacy and Therapeutics (P&T) Committee
Your Pharmacy Benefit Manager (PBM) provides a list of covered drugs, called a formulary. The curation and management of this list, and any other clinical guidelines or policies, is part of the responsibility of the P&T Committee. Their role in this process is essential to successfully managing your pharmacy program.
Pharmacy & Therapeutics (P&T) Committees, made up of healthcare professionals like physicians and pharmacists, play a critical role in shaping pharmacy benefit plans. Their responsibilities include:
- Medication safety and effectiveness: Evaluating drugs based on clinical evidence and improving treatment outcomes
- Regulatory compliance: Ensuring adherence to regulations for each medication
- Guidance on emerging therapies: Reviewing new drugs and indications as they come to market and making recommendations for placement on the formulary
Their decisions directly impact patient outcomes, treatment access, and overall plan performance. However, when P&T members are employed by the same Pharmacy Benefit Manager (PBM) that stands to gain from certain medication placements on a formulary, a conflict of interest may arise.
Why an Independent P&T Committee Matters
An independent P&T Committee, free from PBM influence, offers clear advantages:
- Formulary decisions based solely on clinical evidence
- Improved transparency and accountability
- Reduced risk of decisions being driven by rebates or financial incentives
As scrutiny around fiduciary responsibility for those managing benefits grows, an independent P&T Committee can play a crucial role in mitigating risk. Members from diverse professional backgrounds with no financial ties to the PBM ensure that decisions are made in the best interests of the plan and members, and that their fiduciary duty is being upheld.
P&T Committee Independence Means Aligned Incentives
When your pharmacy partner maintains its own P&T Committee that is fully separate from the PBM, you gain a powerful ally that puts your goals and your members first. A captive, unaffiliated group of physicians and pharmacists ensures your interests are aligned and protected through an independent review and analysis of drug therapies that are available which ensure appropriate clinical management, free from conflicts of interest. With this unbiased oversight, medication decisions remain patient-centered, transparent, and grounded in best clinical practices. As more medications come to market each year, with increasing complexities and costs, this independence will be key to managing a successful pharmacy program.
