Tag Archives: prior authorization

Surescripts Further Streamlines the Specialty Medication Process

Surescripts has now further streamlined the specialty medication process with two new network services

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

The specialty pharmaceutical hub market continues to evolve entering 2019 with new entrants, investment, and consolidation

Specialty Pharmaceutical Hub Services Providers 2019 Report

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 […]

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 […]

Specialty Drug Spend Under the Medical Benefit

Continuation in rising costs of specialty drugs and maybe accelerate in next 1-2 years: Randy Vogenberg

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 […]