Perry Cohen, Chief Executive Executive of the TPG Family of Companies, recently wrote an article about the next generation of PBMs in Managed Healthcare Executive.
The COVID-19 pandemic has had a deep and profound impact on American businesses both large and small. As the country inches back to a “new normal,” business leaders have to deal with the cost of healthcare as a significant issue to their bottom line. Managing pharmaceutical costs will continue to be a major priority for employers.
During the last few years, employers, patients, pharmacies, pharmaceutical companies and the government have become “fed up” with the PBM cartel that exists in the marketplace. The “old guard” PBMshave been reinventing themselves through mergers and acquisitions. Promises of lowering drug costs have not materialized. New PBM entrants have emerged to bring new technology, a simpler business model, and more transparency. I propose to lay out a road map of where we are today and a guide to the market dynamics in the making.
Dr. John Vazquez is a Physician Consultant with TPG International Health Academy (TPG-IHA). TPG-IHA has hosted educational programs for senior healthcare executives for 25+ years, holding week-long Educational Summits in over 30 countries across the globe. The Academy is powered by three pillars: education, networking, and cultural immersion.
Michelle is a Senior Consultant for The Pharmacy Group (TPG). TPG provides consulting services to healthcare service, information technology, and pharmaceutical companies to grow revenue and improve the financial performance of their products and services.
Sue is a senior consultant for The Pharmacy Group (TPG). TPG provides consulting services to healthcare service, information technology and pharmaceutical companies to grow revenue and improve the financial performance of their products and services.
Gayle is a Senior Consultant with TPG Data Services (TPG-DS). TPG-DS and our team of senior healthcare and clinical consultants are transforming the way providers and payors monitor healthcare information to control costs and enhance efficiencies.
Nancy is a Senior Vice President with The Pharmacy Group, responsible for all financial aspects of the TPG Family of Companies, as well as operational matters. She joined The Pharmacy Group in March 2012, in addition to performing the overall financial management she evaluates project profitability and pricing, manages cash flow, analyzes financial performance, and makes financial recommendations. Additionally, she handles HR functions, and frequently is involved in client contracting.
Jeff joined The Pharmacy Group (TPG) in August 2008 to support its administrative functions. Over the years he has taken on additional responsibilities including marketing initiatives, client communications, and general web support. As a vice president Jeff is primarily responsible for attendee recruitment for all TPG activities, from the planning and strategy of recruitment to the execution and oversight of those initiatives.
Mr. Brook has over 30 years in health care industry management and consulting. He has managed medical and health economic educational programs, convention activities, and promotional product support as both an employee and a consultant. He has worked on market access programs with the National Payor Roundtable since the organization formed in 2005, (as the National Managed Care Roundtable). He managed the daily operation of a pharmacy benefit manager’s formulary programs and was instrumental in the development and implementation of over 20 custom formularies. Mr. Brook has worked with state and federal agencies in refining the diagnosis-related-group system, in developing the resource-utilization-group system—part of the U.S. Federal Long-Term-Care Minimum Data Set, and in developing a mental health classification and reimbursement system. Mr. Brook has taken an active role in the developing and reporting the results of the National Payor Roundtable advisor survey. He reviews for several journals including the American Journal of Managed Care and Current Medical Research and Opinion. He has a variety of therapeutic experience with marketed and developmental products and holds several degrees from Rensselaer Polytechnic Institute, including an M.S. in operations research and statistics, an M.B.A. in health systems finance, and a B.S. in management information systems.
Dr. Sax is co-founder and President of The Pharmacy Group LLC in Glastonbury, Connecticut where he provides marketing services to healthcare service providers; pharmaceutical, biotech, and medical device clients; and information technology and companies to grow revenue and improve the financial performance of their products and services.
Rich Balest has served as a health industry consultant utilizing over 25 years of experience in data mining, data modeling, data warehousing, and information delivery. Rich has comprehensive experience analyzing detailed claims and eligibility from CMS, insurance companies, and managed care organizations including prescription benefit managers (PBM), and account and medical record detailed patient data from hospital patient accounting systems, clinical ancillary systems, and professional and institutional billing systems.
Sarah is a Vice President of Business Development for The Pharmacy Group (TPG). Her primary responsibility is coordinating business growth across the various LLCs in the TPG Family of Companies. She joined The Pharmacy Group in February 2015— initially to augment the organization’s business development and administrative activities. In the years since she has worked on marketing initiatives, client communications, general web support, and program development.
Marjorie Pestel Zimmerman, MS, BS Pharm, is a registered pharmacist with diverse experience in the healthcare industry. During her practice in a large tertiary care center, she held numerous positions, including decentralized clinical pharmacist and Assistant Director of Operations within the pharmacy department. As a consultant for a psychiatric hospital, she performed medical staff drug usage evaluations and led patient medication groups.
In August 2015, Leon Edelsack became the President of TPG Healthcare Consulting (TPG-HC) and also serves as the president of TPG-HC’s sister company, TPG Data Services (TPG-DS), a position he has held since 2009.