Industry consultants from Milliman Inc. assert in a July 11
report that blockchain — which is described as a real-time digital ledger for
building secure networks — "could potentially transform the relationship
between payers, pharmaceutical manufacturers, wholesalers, and pharmacies by
offering an alternative, transparent mechanism for processing, pricing, and
validating prescription transactions."
Using blockchain technology, payers and pharmacies would reduce the time they spend validating insurance coverage, making phone calls and managing data, Milliman explains. The firm is urging PBMs to work to "evaluate a blockchain alternative now with an eye toward a more efficient drug financing system" capable of handling additional technology improvements.
"We're just trying to get people thinking outside the box, and I believe blockchain has applications with supply chain management, claim-processing and transparency to the consumer," says Brian Anderson, a principal for Milliman and co-author of the blockchain paper.
In the Milliman report, Anderson and his colleagues, Gregory Callahan and Michael DiPrima, note the current electronic approach to processing pharmacy claims is a sometimes opaque, centralized database management system managed by the PBM.
By contrast, blockchain's database management system model would be decentralized. Milliman explains that means a distributed network of "nodes" would validate all transactions and would store data throughout the distributed network rather than in a centralized server.
The Milliman consultants conclude blockchain technology "appears to hold great promise for the PBM marketplace." But they concede there are obstacles to overcome, explaining that while blockchain has shown great potential for security in cryptocurrency, its true potential in health care has not yet been evaluated.
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