ARTIFICIAL INTELLIGENCE: REVOLUTIONIZING PHARMACY BENEFIT MANAGEMENT SYSTEMS

Abstract

The revolutionary effects of artificial intelligence on Pharmacy Benefit Management systems and the larger healthcare sector are examined in this thorough article. The article looks at how AI is transforming important PBM functions such as prior authorization procedures, data processing, and claims automation. It illustrates the important role of AI in increasing operating efficiency, cutting costs, and improving healthcare delivery through a thorough analysis of market trends, implementation tactics, and operational outcomes. The article covers a wide range of AI implementation topics, from early integration difficulties to measurable advantages and long-term effects, offering insightful information to healthcare companies thinking about implementing AI in their PBM operations. It specifically explores how sophisticated algorithms and machine learning capabilities in AI technologies are changing conventional PBM procedures. These technologies make it possible to analyze prescription patterns more thoroughly, identify fraud more effectively, and predict medicine needs more accurately. The article also emphasizes how important AI is to expediting prior authorization procedures, which have long been a major bottleneck in the provision of healthcare. It also looks at the long-term return on investment, operational cost savings, and initial investment requirements as well as the economic effects of adopting AI. According to the results, companies that integrate AI into their PBM operations are better equipped to handle the escalating difficulties associated with healthcare cost management while upholding excellent patient care standards.