Matt Jarvis is the SVP of Strategy in Lockton’s national pharmacy practice. He has a PharmD (Doctor of Pharmacy) and has worked in both retail and consulting pharmacy roles. Matt is a subject matter expert in understanding current pharmacy market pricing, supply chain, and medication delivery to the consumer. He leads the development and implementation of innovative clinical solutions that drive optimal management in specialty drugs for Lockton clients.

Mentioned on the Show

Timestamps

(00:00:00) – Matt Jarvis, PharmD joins his colleague O’Brien McMahon on the People Business Podcast

(00:03:48) – What is the structure of a pharmacy plan and how does it differ from the medical plan? What are the common misconceptions?

(00:05:43) – What a PBM is and why does it exist? Why isn’t pharmacy handled through the regular health plan?

(00:08:12) – Why don’t drug manufacturers sell directly to health plans and what the steps are from drug creation to pharmacy purchase?

(00:09:44) – What is a formulary?

(00:13:09) – Why is there is a disconnect between doctors prescribing medications and what’s actually covered by a plan?

(00:14:37) – What is the role of drug reps in the overall pharmacy system?

(00:18:43) – Is AI influencing how doctors prescribe medications?

(00:19:54) – What role does the pharmacist plays in the current system?

(00:21:18) – Do pharmacists have any ability to intervene or help patients navigate the formulary, or do they just dispense whatever is prescribe?

(00:23:30) – What is prior authorization, and is it driven by clinical or financial outcomes?

(00:27:36) – What are the different drug tiers and what qualifies a drug for each tier?

(00:28:48) – What qualifies as a specialty drug?

(00:30:20) – What is the difference is between prior authorization and step therapy?

(00:31:40) – What role do generics in the current pharm landscape?

(00:40:16) – Step therapy and biosimilars: how they each work

(00:42:38) – Where does mail order fit into the pharmacy system?

(00:48:00) – Rebates: the complicated and confusing system of paying for drugs

(00:56:21) – Emerging PBMs and when it makes sense for clients to switch

(00:59:33) – How can employers vet new-model PBMs when traditional rebate-heavy models look better on a spreadsheet?

(01:02:59) – Closing thoughts from Matt Jarvis