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Don Anderson

Don Anderson, Pharm.D., is Vice President of Pharmacy at OrionRx (Pinnacle Rx Solutions), a pharmacy benefit manager focused on pharmacy cost containment for employers and health plans.

Oct 6, 2026

37:00
And I think that people don't really understand that they have choices to make in a pharmacy plan because they just kind of a lot of times buy what was presented to them, right? So what can you do to contain costs? How can you kind of dig into that and try to save some money?
37:14
Yeah, so on the plan sponsor side, one of the things that we find a lot of success with is our clinical intervention program.
37:21
So I've got a team of pharmacists and nurses that are looking at high-cost claims coming through, and we set that threshold differently depending on the plan themselves.
37:29
But anything that's in excess of $5,000 or $6,000, we're looking at pretty closely.
37:35
Is that claim the right claim in that member's health profile? Does it make sense right now? And if it doesn't, what can we do with a provider to come up with a better solution? Um, and a lot of that, I'll call it academic detailing, right? Pharmaceutical reps are detailing doctors to prescribe certain things.
37:51
We're going back and behind them, reeducating that provider onto a less costly alternative with similar likely outcomes.
37:58
Um, I've taken a plan in from a large PDM competitor and we've shaved anywhere from 15 to 17 points right off of the drug spend in the first 12 months, just doing that alone.
42:20
But the drug costs... have come down on glp-1 drugs in in 2026 i've noticed tell me about this are plans covering it now in your perspective are more plans covering it than maybe even a year ago and if so are they building in requirements criteria such as you know body mass obesity that sort of thing or are they just letting people that anybody that wants to get skinny get skinny

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