Tag Archives: formulary

PBM P&T Practices The HEAT Initiative Is Gaining Momentum

Care outside the hospital, like P&T committee responsibilities outside the hospital, is necessarily different. New processes and solutions, such as cloud computing, can help improve performance and transparency of benefit management for purchasers or users of health care services. The current role of PBMs includes concurrent improvement in health outcomes, so the take-home message is […]

Increasing Demand for Drug Based Outcomes

Specialty Pharma Services

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 […]

Proposed Changes to Rx Information Required in SBC

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). […]

Current PBM Model Threatened by New-Entity PBMs

Changes are happening in the PBM market. Traditional services offered by PBMs will be supplanted by new PBM entities that will develop formularies among the services they offer. The new entity PBMs manage and supplement PBM services as an advocate for health care payers. Services include prescription claims analysis and consultation, drug coverage management, PBM contracts […]

John Santilli quoted in Modern Medicine: Ebola clinical activity heats up with vaccine candidates in works

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