Step therapy has been used to augment prior approval (PA) processes as a method to control utilization and costs of pharmacotherapy by managed care/third party administrators
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. 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 […]
Employer Perspectives Specialty Drug Step-Therapy Program Evaluation American Health and Drug Benefits, September 2016 Vol 9, No 6 – Industry Trends Matthew Harman, PharmD, MPH, Director, Clinical Pharmacy Strategies Employers Health, Columbus, OH F. Randy Vogenberg, PhD, RPh, Strategic Advisor and Co–Project Leader, Midwest Business Group on Health National Employer Biologics & Specialty Drug Initiative […]
Employers and insurers are responding to costs of expensive drugs like Sovaldi with step therapy, or higher tiers of drug-payment categories, and shifting the site of care from hospitals to physician offices, says John Santilli, partner in Access Market Intelligence. Read more here: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-five-industry-challenges-2015?page=0,7