Drug costs

Prime Therapeutics has studied the costs and clinical events relationship among their members using a controlled substances (CS) score algorithm that identifies potential overuse/abuse of opioids/controlled substances.

Four new drugs and a biosimilar should be on your radar.

In this Q&A, a presenter at the upcoming ASH conference discusses new hematology payment models and the top challenges payers face in this area.

FDA’s approval of Vertex Pharmaceutical’s groundbreaking lumacaftor/ivacaftor (Orkambi) for cystic fibrosis (CF) is the first drug to treat the underlying cause of CF in people ages 12 and older with two copies of the F508del mutation.

In this commentary, three pharmacy experts explain why they believe the 340B Drug Program is a needed safety net for safety net hospitals.

Coverage decisions about new technologies, including access and cost considerations, are a major challenge for public and private payers.

A large chunk of what insurers spend can be saved by improving medication adherence through medication therapy management done right.

FDA’s approval of the first generic version of Copaxone for treating patients with relapsing forms of multiple sclerosis has industry insiders contemplating the impact on the generics market as well as payer coverage strategies.

Critics charge that the practice of adverse tiering to deter costly patients is violating the Affordable Care Act's coverage mandate.

Consensus is building on the promise of genetic testing and other technological advances to help individualize testing, prevention and treatment for better outcomes.

Both public and private purchasers are in an important position to act as catalysts of change in managing specialty pharmacy.

Increasing unnecessary regulations on drug plans could inflict higher costs on the 220 million Americans who get their medications through a managed drug plan, according to a new report.

Controversy surrounds the 340B Drug Discount Program, and many industry leaders agree that the healthcare law plays a large part.

Health plans struggling to rein in pharmacy costs are using mail service, disease management programs, financial incentives for generics, member cost sharing, and, increasingly, limited and closed formularies.

Two recent studies show that members who obtain health insurance through state or federal insurance exchanges use more specialty and generic drugs than their counterparts in commercial plans.

Health insurer Anthem has reached a deal that makes Gilead Sciences’ Harvoni the primary treatment for patients with hepatitis C, following close on the heels of hep C drug announcements by CVS Health and Express Scripts.

Drug shortages and manufacturer consolidation are leaving their imprint on the price of some generic drugs.

Retail prices for brand name prescription drugs widely used by older Americans shot up by an average of nearly 13% in 2013, more than eight times faster than the 1.5% general inflation rate, according to a new AARP Public Policy Institute report.

espite the fact that approximately 2.74 million patients used anti-obesity drugs in 2011, according to information services company IMS Health, the majority of health plans are following the lead of the Centers for Medicare and Medicaid Services and not covering them.

Industry experts question whether the high cost of treatment is beneficial to patients and health plans

Optimize benefit plans to motivate patients to take advantage of cost-effective drugs

AMCP and NCPA are generally relieved that feds won't interfere with drug prices

Drug prices show staggering markup

PBMs are moving products to non-covered status

The two companies have signed an agreement that commits them to a “50/50 joint venture” that may dominate the US market.

Fear and dosing schedules are barriers

Discussion leaves a sense of uncertainty as to how coverage rules will play out

Will ACA exchanges earn 90% satisfaction ratings someday?

Drugs are free of interferon and aim to shorten treatment time

Test patient response with initial 14 day fill