Pharmacy Benefits Management

July 15, 2014 | Anthony Brino

Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive's spines.

July 7, 2014 | Anthony Brino

The growth of total U.S. medical costs is slowing down, but one segment is expanding fast enough to catch insurers by surprise.

June 17, 2014 | Anthony Brino

Pressure is growing on insurers to stop using mail-order pharmacies for speciality medications, and also on benefits managers to find new ways to get lower drug prices.

June 12, 2014 | Anthony Brino

Sovaldi has brought high prices of specialty drugs to the fore. Less examined so far are proactive approaches insurers and drug benefits managers can use to curb the growth trend without sacrificing quality or access.

May 27, 2014 | Charles Ornstein, ProPublica

The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.

May 21, 2014 | Anthony Brino

The breakthrough hepatitis drug Sovaldi has sparked a vigorous debate about the financial sustainability of U.S. healthcare and the role of government in regulating prices.

May 21, 2014 | Anthony Brino

In an era of increasing consolidation, some insurers are taking a slightly different route on the health reform journey.

May 8, 2014 | Anthony Brino

Amid the rise of high-deductible health plans and the growing prevalence and burden of chronic diseases, some argue that it may time to rethink the concept and regulation of preventive services.

April 29, 2014 | Kelsey Brimmer

A recent analysis of the federal government's 340B drug discount program suggests that eligibility is too broad and that lawmakers need to tighten it, which may mean that hundreds of hospitals currently in the program would be booted out.

April 28, 2014 | Anthony Brino

Left as-is, current exchange formulary and network search technology has the potential for a lot of consumer dissatisfaction and backlash.

April 9, 2014 | Anthony Brino

New public insurance exchange enrollees are starting to use their prescription drug benefits, and so far their per-member costs are looking higher than in the average commercial plan.

April 7, 2014 | Frank Irving

Patients don't fill first-time prescriptions nearly one-third of the time, which makes "nonadherence" an important factor working against proper disease management.


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