Category Archives: Specialty Drug

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 […]

Continue reading →
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 […]

Continue reading →
Specialty Drug

CVS Health Acquires Omnicare

Posted on by John Santilli

CVS Health Acquires Omnicare – Well, the guessing game is over as CVS Health acquires Omnicare. The Pharmacy in Long-Term Care market has a new industry leader as CVS Health will see if their business model translates to the long-term care pharmacy market. The LTC market is a different business and CVS is moving from their traditional “core competency”. It […]

Continue reading →
Specialty Drug

Proposed Changes to Rx Information Required in SBC

Posted on by John Santilli

Proposed Changes to Rx Information Required in SBC, Greg Judd, CEBS The American Medical Association (AMA) and the Pharmaceutical Research and Manufacturers of America (PhRMA) are asking regulators to build more information about major medical plan drug coverage into the next revision of the Summary of Benefits and Coverage (SBC) and the Uniform Glossary (LifeHealthPro). […]

Continue reading →
Specialty Drug

Planning a Specialty Drug Strategy Through 2020

Posted on by John Santilli

Planning a Specialty Drug Strategy Through 2020 – Traditional approaches are not suited to managing the cost of specialty drug therapies By Gregory Judd, CEBS, and Randy Vogenberg, PhD  5/4/2015 (originally published by Society for Human Resource Management (SHRM))   The specialty drug tsunami is picking up strength and is about to come crashing down on […]

Continue reading →