CPBP Practice Test

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CPBP Practice Test (V1)

Dive into practice questions

Question 1

A Pharmacy Benefits Manager (PBM) is designing a new formulary for a commercial health plan. What is the primary purpose of placing a high-cost, multi-source brand drug on a non-preferred tier (e.g., Tier 3)?

  1. To guarantee the manufacturer a certain market share.
  2. To encourage the use of more cost-effective, clinically equivalent alternatives on lower tiers (e.g., generics or preferred brands).
  3. To make the medication available to all members without any cost-sharing.
  4. To comply with a federal mandate requiring all brand drugs to be on Tier 3.

Question 2

A pharmacist at a PBM is conducting a retrospective Drug Utilization Review (DUR). What is the main goal of this type of review?

  1. To block a prescription from being filled at the point of sale.
  2. To identify and correct potential medication problems before the patient receives the drug.
  3. To analyze prescribing patterns and patient medication history over a period of time to identify opportunities for improving care and reducing costs.
  4. To directly discipline physicians with poor prescribing habits.

Question 3

According to CMS guidelines for Medicare Part D, which of the following patients would be eligible for a Medication Therapy Management (MTM) program?

  1. A patient with any single chronic condition, regardless of medication count or cost.
  2. A healthy patient taking only one low-cost generic medication.
  3. A patient who is a dual-eligible (Medicare and Medicaid) and takes multiple high-risk medications.
  4. A patient who has multiple chronic conditions (e.g., diabetes, hypertension, dyslipidemia), takes numerous Part D drugs, and is likely to incur high annual drug costs.

Question 4

Besides administrative fees, what is a primary source of revenue for a Pharmacy Benefit Manager (PBM)?

  1. Co-payments collected directly from patients at the pharmacy.
  2. Rebates negotiated with pharmaceutical manufacturers for preferred placement on formularies.
  3. Dividends from owning retail pharmacy chains.
  4. Grants from the National Institutes of Health (NIH).

Answer Key

  • Question 1: B. To encourage the use of more cost-effective, clinically equivalent alternatives on lower tiers (e.g., generics or preferred brands). (The tiering system is designed to steer members and prescribers towards lower-cost options, thereby managing overall drug spend for the health plan.)
  • Question 2: C. To analyze prescribing patterns and patient medication history over a period of time to identify opportunities for improving care and reducing costs. (Retrospective DUR looks at past claims data to find patterns of overuse, underuse, or inappropriate use of medications, which can then be addressed through educational outreach.)
  • Question 3: D. A patient who has multiple chronic conditions (e.g., diabetes, hypertension, dyslipidemia), takes numerous Part D drugs, and is likely to incur high annual drug costs. (CMS sets specific criteria for MTM eligibility, which include having multiple chronic diseases, taking multiple Part D drugs, and reaching a certain annual cost threshold.)
  • Question 4: B. Rebates negotiated with pharmaceutical manufacturers for preferred placement on formularies. (Manufacturer rebates are a significant revenue source for PBMs, obtained in exchange for giving a drug favorable status on a formulary, which increases its market share.)