Tag Archives: medical benefit

Optum Specialty Fusion™ Launched To Streamline Care and Lower Costs

Optum Specialty Fusion™ was launched to streamline treatment decision-making for care providers, helping patients get on their therapies faster

Large Insurers Implementing White Bagging Policies

Large insurers are implementing policies requiring health care providers to get provider-administered therapies from specialty pharmacies

Lundbeck’s Vyepti Distributed by Only Two Specialty Pharmacies

Lundbeck has named AllianceRx and Orsini as the only two specialty pharmacies to distribute Vyepti

Insurers Using Site of Care Optimization to Reduce Specialty Drug Costs

Manufacturers are increasingly being affected by the commercial insurance market’s shift of medical coverage policies to lower-cost alternate sites

Will Diplomat Pharmacy Survive?

Diplomat found that competing successfully with large specialty pharmacies owned by Cigna/ESI, CVS Health/Caremark and UnitedHealth/OptumRx has been more difficult than projected

Diplomat Looking to Improve CastiaRx’s Performance

Diplomat has realized it needs to accelerate the implementation of its new payer sales strategy for CastiaRx

Pharmacy Benefit Manager Market Continues to Evolve

Pharmacy Benefit Manager Market Continues to Evolve. Recent consolidation in the pharmacy benefit manager (PBM) industry has resulted in major market share divided by the three market leaders: Express Scripts, CVS Health (Caremark), and OptumRx (UnitedHealth Group). PBMs remain searching for a value proposition beyond drug distribution with their employer clients. As long as PBMs […]

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 […]