Pharmacy Benefits Management

November 10, 2014 | Anthony Brino

Pre-reform underwriting approaches for speciality medications like HIV/AIDS drugs are not going to fly in the new health insurance market, as regulators and patient advocates intervene to challenge a range of practices.

October 13, 2014 | Rich Pizzi

Cost-sharing in traditional Medicare is on the rise, and benefit designs in Medicare drug plans are changing.

October 10, 2014 | Anthony Brino

The new hepatitis C treatment Sovaldi has driven debate over drug costs for close to a year, but it’s also been a case study in access and coverage in public payer programs.

October 3, 2014 | Anthony Brino

Drug benefits stand as some of the most consequential consumer confusions that can arise in public exchanges, increasing the onus on insurers to improve the design and explanation of formularies.

September 23, 2014 | Anthony Brino

A shrinking number of Medicare Part D drug plans is set to bring beneficiaries some more low-cost choices, but also some potentially confusing benefit designs.

September 18, 2014 | Anthony Brino

Struggling Medicare Advantage and Part D drug plans are being given a last minute reprieve, although they will need to show more improvement if they want to stay alive longer than a year.

September 10, 2014 | Anthony Brino

UnitedHealth Group's big data venture is plying new waters in deals with several powerful healthcare institutions, trying to create value with one of healthcare's largest databases.

September 8, 2014 | Anthony Brino

The currents of health reform and consumerization are getting more treacherous for incumbent hospital businesses, but payers and retailers, especially, have waves to ride.

September 4, 2014 | Anthony Brino

The pharmacy benefits industry is challenging a new state law, trying to protect a key management tool that insurers, employer groups and public payers have been relying on for cost stability.

August 19, 2014 | Anthony Brino

Insurers may need to find new ways to control costs for specialty drugs, as more states add limits to cost-sharing and utilization continues to grow.

August 14, 2014 | Anthony Brino

A once-promised truth in pharmaceutical benefits management is unravelling, leaving payers exposed and researchers scratching their heads.

August 12, 2014 | Anthony Brino

Amid challenging trends in drug prices and formularies, independent pharmacy advocates are pushing for a new "any willing" provider mandate in Medicare Part D.

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