Pharmacy Benefit - Managed Healthcare Executive

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Pharmacy Benefit
  • Niche-buster drugs launch next market evolution


    Will generic drugs, patent expirations, safety issues and a dry pipeline for high-incident diseases make room for a new drug paradigm?

    Plans vary in specialty-drug benefit models



    A recent online survey from Serono Injectables Digest, which includes data from 83 health plans, looked at the challenges and strategies of managing specialty pharmacy, provider reimbursement and cost sharing.

    Statins, fibrates valuable in heart disease treatment


    Statin medications lower cholesterol levels and have an anti-inflammatory effect. They should be used in combination with lifestyle changes to reduce heart disease risk.

    Plan, PBM programs help identify prescription drug abusers



    How much attention is being paid to abuse of prescription drugs? One group, pharmacy benefit managers, are beginning to take a closer look by creating programs to identify members who may be abusing prescription drugs.

    Off-label prescribing might get boost from FDA



    Using drugs for conditions other than what's on the label is not new, but it may receive more encouragement if draft guidance from the Food & Drug Administration (FDA) is approved. Allowing more off-label use might also increase payers' pharmacy costs.

    Medication therapy management bumps up pharmacists' roles


    MEDICATION THERAPY Management (MTM) services introduced in 2006 under Medicare Part D have prompted pharmacists to adopt expanded roles in the commercial setting, such as performing a comprehensive medication review and monitoring a patient's response to therapy. One of the main caveats, however, is the lack of standardized reimbursement for pharmacists' services.

    Lack of education affects behavioral health medication compliance



    Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.

    Biogenerics Years Away from Market Pipeline



    Biogenerics will not be taking the U.S. marketplace by storm any time soon. Approval of biogenerics is creating a rift between innovators and generic manufacturers and is putting data exclusivity and interchangeability to the test

    Mail-order pharmacy steps up patient services



    What works for retail pharmacy patients should work for mail-order recipients, namely, personalized drug counseling. When consumers pick up their prescriptions at a local pharmacy, they have access to pharmacists who can advise them on how and when to take medications, warn them of potential side effects and discuss generic alternatives.

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