INSTRUCTIONS
Use materials covered as part of this course (posted in Canvas and from in-class activities) and
from elsewhere to answer the following questions. These questions are reflective inquiries,
answer accordingly. In other words, reflect.
OUT-OF-POCKET EXPENSES
Question #1
Please answer the following questions/statements.
Explain to a patient what out-of-pocket expenses are and what is included.
What impact do these expenses have on a patient’s access to care?
What impact do these costs have on population health?
FORMULARIES
Question #2
Please answer the following questions/statements.
How would you explain a formulary exclusion to your patient?
In your experience, are formularies useful? Why or why not?
PHARMACY BENEFIT MANAGERS
Question #3
Please answer the following questions/statements.
What roles do PBMs play in healthcare financing?
What are some of the current issues surrounding PBMs?
What will be the key impacts, according to you, of the Supreme Court’s
ruling in Arkansas vs. PBMs case?
Explain your answers.
AFFORDABLE CARE ACT
Question #3
Please answer the following questions/statements.
How are circumstances in the healthcare system similar now to the year 2009?
How will these similarities drive healthcare reform over the next two years?
What do you suggest be done to help solve some of the health care problems
we see now?
Support your reflections with facts.
Reflections must be posted by the due date using 12-point, Times New Roman font, and
1.5 line spacing.
resources
https://www.communityoncology.org/pharmacy-benefit-manager-horror-stories-part-v/
