Tag Archives: benefit design

Metro Areas Where Employers Influence Cancer Coverage Costs

Metro Areas Where Employers Influence Cancer Coverage Costs. Employers currently represent approximately 60% of the commercial insurance market dollars. The Employer commercial insurance market consists of more than 95,000 companies with self-insured plans, eighty percent of whom have less than 2,000 employees. Entering 2017, these employers face double-digit increases in the cost of prescription drugs […]

Designing Pharmacy and Medical Benefits for Cancer Care

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 […]

Health Benefits/Pricing Implosion

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 […]

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

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 […]

A Call to Action to Address Burden of Unintended Pregnancies in Plans’ Benefit Design

Benefit Design – A Call to Action to Address Burden of Unintended Pregnancies in Plans’ Benefit Design F. Randy Vogenberg, PhD, RPh Partner, Access Market Intelligence, Greenville, SC Adjunct Professor of Pharmacy Administration, Presbyterian College School of Pharmacy, Clinton, SC Adjunct Instructor, Outcomes and Health Policy, University of Illinois at Chicago College of Pharmacy Originally […]

Planning a Specialty Drug Strategy Through 2020

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 […]

Pharmaceutical Growth Driven by M&A and Shareholder Value

Pharmaceutical Growth Driven by M&A and Shareholder Value – Biologic and Pharmaceutical companies, along with their financial advisors or venture capital partners, have used mergers and acquisitions over the years to create value in order to keep their leading positions in a changing market. The era of pharmaceutical companies relying on blockbusters for their growth […]

Seeking Value: Managing Specialty Medications and Medication Adherence

Amid the constant change churning the health care marketplace, employers have the opportunity to use value-based tactics to get more for their health benefits, including pharmaceutical spending that is currently the biggest driver of rising health care costs. That message was echoed by all four speakers at the Alliance Learning Circle on “Doses and Dollars: […]