Specialty Drug

Future of Specialty Pharmacy and More

Posted on by John Santilli

Future of Specialty Pharmacy – Recent events involving Valeant and Philidor have caused an uproar in the marketplace along with the Turing Pharmaceutical (and generics) mess around pricing. Now the NY Times casts the light on Horizon and Linden illustrating the bad without much good around stakeholder relationships that pharma firms have utilized. Due to the evolution […]

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Dr. Randy Vogenberg

Closing Gaps in Health Plan Performance with Stakeholder Collaboration

Posted on by John Santilli

Closing Gaps in Health Plan Performance with Stakeholder Collaboration Published in American Health & Drug Benefits, October 2015, Vol 8, No 7, Optimizing Rheumatoid Arthritis Therapy: Using Objective Measures of Disease Activity to Guide Treatment F. Randy Vogenberg, PhD, RPh, Partner, Access Market Intelligence Employers/Health Plans: For most commercial health plans and employer-sponsored health plans, immunology represents a […]

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Specialty Drug

Specialty Drug Wave Hitting Medical and Pharmacy Plans Harder: Trends versus reliable benefit strategy to handle the impact through 2020?

Posted on by John Santilli

Specialty Drug Wave Hitting Medical and Pharmacy Plans Harder: Trends versus reliable benefit strategy to handle the impact through 2020?The U.S. now has two different markets resulting from implementation of the Affordable Care Act (ACA) and resultant trends. Related to specialty or biological drugs, public sector CMS’s forecast of drug spending is somewhat counterintuitive, given […]

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Specialty Drug

Buy and Bill Trend: Are there Contradictions to Vendor or Pharma’s Reported Data

Posted on by John Santilli

Buy and Bill Trend:  Are there Contradictions to Vendor or Pharma’s Reported Data Distribution based sales of specialty pharmaceuticals raises critical issues for manufacturers and providers as plan year 2016 decisions have been made and 2017 preparations begin by purchasers. For pharmaceutical manufacturers, the dilemma arises when (1) reimbursement is limited or eliminated under benefit […]

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John Santilli

The Anthem Cigna merger: 10 things to Know

Posted on by John Santilli

The Anthem Cigna merger: 10 things to Know – Published July 24, 2015 By Tracey Walker, Managed Healthcare Executive Anthem’s acquisition of Cigna is being called the first “merger of titans” by industry watchers. The forces of consolidation are well under way and the merger was not totally unexpected—all of insurance is going through similar […]

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Market Intelligence

Blues Plans Can Use Various Tactics to Mitigate Generic Drug Price Inflation

Posted on by John Santilli

Blues Plans Can Use Various Tactics to Mitigate Generic Drug Price Inflation, Published in The AIS Report on Blue Cross Blue Shield Plans, V14, Number 7 July 2015         Randy Vogenberg, Ph.D., Partner, Access Market Intelligence notes that the FDA has cited “quality and manufacturing issues” as “a major reason for drug shortages. Most […]

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Market Intelligence

Why CVS Recent Deals Change the Specialty Landscape

Posted on by John Santilli

Why CVS Recent Deals Change the Specialty Landscape – Following a similar path as in the late 1990’s with long term care pharmacy, specialty pharmacy has matured enough to undergo consolidation and roll-up into larger healthcare entities. Specialty represents a small distribution volume in the retail pharmacy space but also results in the greatest profit […]

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Specialty Drug

Employers Medical Stop Loss for Specialty Rxs

Posted on by John Santilli

Employers Medical Stop Loss for Specialty Rxs – Employers will continue to experience escalating specialty Rx costs.  Effective but expensive non-substitutable products emerging from pharmaceutical manufacturers’ development pipelines will quickly and sharply drive both pharmacy and medical benefit year-over-year spending increases. Traditional risk management tools, like stop loss insurance policies are designed to mitigate risk […]

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