Department of Defense Drug Cost-Savings Programs. The Department of Defense pharmacy program is on to track to slice $1.3 billion off projected drug costs from 2014 to 2019, thanks to higher beneficiary co-pays, tighter point-of-service rules and recent streamlining of prescription drug processes across the military, explained Dr. George E. Jones, chief of pharmacy operations […]
Increasing Demand for Drug Based Outcomes – Outcome-based contracts are a relatively new and growing contracting methodology focused on shifting reimbursement from volume to value. The contracts are between a health plan and manufacturer where reimbursement is dependent on pre-defined outcome metrics focused on improving patient responses/health. Currently, the relationship between the pharmaceutical manufacturer, the […]
Designing Pharmacy and Medical Benefits for Cancer Care: An Employer Perspective – published in Value-Based Cancer Care F. Randy Vogenberg, PhD, RPh, FASHP; Catherine E. Cooke, PharmD, BCPS October 2016, Vol 7, No 9 – Employers’ Perspective With the increasing complexity of cancer care after the passing of the 2010 Affordable Care Act, employers as […]
Managed care pharmacy survey findings 2016 Managed Healthcare Executive September 26, 2016 To identify the top managed care pharmacy challenges and what your peers are doing about them, Managed Healthcare Executive, in partnership with Access Market Intelligence and the National Institute of Collaborative Healthcare, conducted its first-ever pharmacy survey during the second quarter of 2016. […]
Telehealth Applications Patient Care Rita M. Marcoux, RPh, MBA; F. Randy Vogenberg, PhD, RPh, FASHP June 2016, Vol 7, No 5 – Employers’ Perspective – Value-Based Cancer Care The term telehealth is used interchangeably with telemedicine by some organizations. However, telemedicine is typically associated with the delivery of traditional clinical diagnosis and monitoring by using […]
Specialty Drug Spend Under the Medical Benefit — Biologic, biotechnology based, rare disease or high cost pharmaceuticals—collectively known as specialty drugs—can be covered under the pharmacy benefit, the medical benefit, or both depending on the plan sponsors’ benefit design required of the payor. On average, up to 50% of specialty drugs are covered under the […]
Health Benefits/Pricing Implosion – The announcement by the Obama administration that it would begin rating health insurance plans based on how many doctors and hospitals they include in their networks along with the announcement the ACA will now (2017) allow the individual deductible to increase to $7150 and $14,300 for family coverage will contribute to a pricing/benefit […]
Ebola is unlikely to become a profitable endeavor for Western pharmaceutical companies, “affecting primarily the poor in Africa with demand for drugs relatively modest,” according to John Santilli, of Access Market Intelligence, which provides market intelligence to the pharmaceutical and healthcare industries. http://formularyjournal.modernmedicine.com/formulary-journal/news/ebola-clinical-activity-speeds-vaccine-candidates-works