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Managed Care March 2007 Louis W. Hutchison	Unable to Carry Cost Burden, Payers Seek Other Remedies The pharmacy benefit landscape of today is all but unrecognizable from its predecessor of just a decade ago. Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Managed Care June 2003 Thomas Kaye	Mail Order Pharmacy -- Savings or Added Cost? Mail order programs can provide savings, but HMOs need to ensure that they are actually receiving sufficient value.
Managed Care December 2003 Tony Berberabe	Why Do FEHBP and Big Unions Excel at Managing Drug Costs? Pharmacy benefit managers can do only so much to keep drug price increases in the single digits. Initiatives instituted by health plans can help in this effort.
Managed Care August 2001 Steve Perlstein	Four-Tier Approach Injects Consumerism Into Drug Benefit In tying copayments closely to the actual cost of medications, Humana takes a step toward promoting awareness of resource use...
Managed Care June 2006 John Carroll	When New Drugs Are Costly, How High to Raise Copays? As some pretty costly, yet very useful, drugs are introduced, will new formulary designs deny access to needy patients?
Managed Care January 2008 Thomas Kaye	Now Is the Time for Pharmacy Performance Incentives We've made strides in increasing the transparency of pricing in the pharmacy supply chain, and now we need to change dispensing behavior.
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Managed Care February 2007 Martin Sipkoff	As Drug Payment Model Changes, Confusion Grows Among Insurers Purchasers are hopeful that life after "average wholesale price" will be simpler, fairer, and, with luck, easier to grasp.
The Motley Fool January 12, 2010 Dayana Yochim	6 Ways to Score Cheap(er) Drugs Stop overpaying for the pills you have to pop with these simple ways to trim your prescription-drug tab.
Managed Care April 2006 Martin Sipkoff	Blues Plan's Bold Move Brings Generics Savings Blue Cross & Blue Shield of North Carolina is waiving its copayments for generic drugs in a unique six-month pilot program.
Managed Care July 2000 John Carroll	Physicians Reconsider Taking On Pharmacy Risk They've been burned here in the past, but physicians - and the HMOs that they contract with - may have learned some lessons.
Managed Care January 2007 Martin Sipkoff	Employers Want Plans & PBMs To Push Hard for Generics Health insurers' aggressive stand on members' use of generic drugs can attract new clients, but does it interfere with the physician-patient relationship?
Managed Care July 2004 Maureen Glabman	Wish List: 10 Things You Want From Your PBM One auditor estimates that 3 percent to 10 percent of pharmacy benefit manager (PBM) claims are processed incorrectly -- always in favor of the PBM.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
Managed Care November 2004	Tiered Formularies Open the Potential for Lack of Access to Needed Drugs Tiered formularies that have additional incentives for preferred medications could create the potential for therapeutic compromises.
Pharmaceutical Executive May 1, 2011 Mason Tenaglia	Out of Control The pharmaceutical industry needs to use new and better data to accurately measure how much it is willing to invest in avoiding plan control.
Managed Care May 2006 John Carroll	Effective Ways To Increase Usage of Generics Generics is one of the few areas where insurance plans can economize effectively. BlueCross & BlueShield of North Carolina is one of many insurers that are changing members' and prescribers' behavior.
Managed Care November 2004 Tony Berberabe	Military Brings Order To Formulary System Congress told the Department of Defense to create a uniform formulary for all the services, and cover all FDA-approved drugs.
Managed Care September 2002 John Carroll	When Success Sours: PBMs Under Scrutiny Pharmacy benefit managers are under fire from many corners. What will the push for transparency mean for the industry?
Managed Care March 2000 Tim Sawyers	Test Prospective PBM Before Signing Contract How to select, then monitor a pharmacy benefit management company, from a consultant and former HMO director of pharmacy services.
Managed Care October 2004 Martin Sipkoff	Not So Much of a Reach: Let Sick Pay Less for Drugs The idea is radical and simple: Those who need medication the most should pay the least. There is evidence that this is cost-effective.
Managed Care November 2006	The Formulary Files Step therapy for antidepressants saves 11.7 percent in one year.
Pharmaceutical Executive February 1, 2014 Jill Wechsler	Drug Coverage, Costs Under Scrutiny Benefits offered by insurance plans on health exchanges and through Medicare are raising concerns about patient access to needed therapies
Managed Care March 2000	Three-tier drug copayments in; closed formularies on way out?
The Motley Fool January 13, 2009 Dayana Yochim	Fiscal Fitness '09: 6 Ways to Score Cheap(er) Drugs Save more than $200 on prescriptions.
Pharmaceutical Executive February 1, 2014 Anbil et al.	Managed Markets: Positioning Your Product For Success with Pull Through Strategies A patient-centric approach to drug development delivers the benefits that actually create value
Managed Care February 2005 Thomas Morrow	Competition Heralds Beginning of Bio-Generics There is very little competition in the biopharmaceutical sector. With the introduction of generic forms of human growth hormone, can managed care get a lower price?
Managed Care September 2007	Income Said To Influence Use of Generics An observational analysis of pharmacy claims collected from 2001 to 2003 finds that where a person lives and the socioeconomic implications of that location have a lot do with his use of generic drugs.
Managed Care April 2005 Thomas Morrow	Specialty Pharmacy Meets Niche Company Expertise As new specialty pharmacy care becomes more dominant, companies devoted to managing these products and their associated costs are finding a market.
Managed Care July 2005 Tony Berberabe	Change in Thinking For Pharmacy Benefits in CDHP The difference between the pharmacy benefit in a consumer-directed health plan and a traditional health plan is greater generic drug utilization.
The Motley Fool May 4, 2011 Jason Knapp	Generic Drugs and Old People Could Make You Rich CVS hasn't generated market-beating returns yet -- but it will.
Pharmaceutical Executive February 1, 2011 Jon Zifferblat	China: Business as UNusual If there is one market that requires a click on the 'refresh' button, it's China. General Biologic provides a snapshot of what's ahead for Big Pharma in the country
Pharmaceutical Executive April 1, 2011	Off-Label But On Point? Use of off-label drugs is a balancing act for physicians, and poses even more problems for pharma. The FDA is moving slowly to help.
Managed Care June 2005 Martin Sipkoff	MMA Formulary Design Requires Health Plans To Control Costs Despite a mandate to adopt utilization management programs and make patients share costs, health plans are still lining up to participate in Medicare Part D.
The Motley Fool April 19, 2011 Bryan White	Rising Star Buy: Medco Health Medco has a much brighter future than its current stock price implies.
Managed Care June 2005	PBMs Get Thumbs up From Satisfied Customers Pharmacy benefit managers that educate physicians on the safety and efficacy of generic drugs or provide them with generic drug samples to increase the use of generics get higher satisfaction ratings than those that don't.
Managed Care November 2005	Recently Introduced Generics Helped Pbm Control Its Costs The top five generic drugs released over the past three years reduced pharmacy spending by 4.8 percent largely due to the timing of the release of generic products to the market.
Pharmaceutical Executive March 3, 2014 Mason Tenaglia	The New Metrics of Market Success Profitability now depends on metrics to help companies answer a key strategic question: "stay the course" with more investment in sales and marketing? Or "stand down" and deploy those scarce assets somewhere else?
Managed Care April 2007 MargaretAnn Cross	Do P&T Committees Have Enough Power? Plans and PBMs are divided about sharing drug prices with clinicians. Is it better to have an administrative committee determine the formulary?
Managed Care March 2008 John Carroll	Should Plans Pay Physicians To Switch Patients to Generics? The AMA calls it a kickback, but the industry sees it as just good practice to give doctors an incentive to get patients on equivalent generics
Managed Care February 2008 Martin Sipkoff	FDA Approach to Generics May Be a Mixed Blessing A recently announced initiative is supposed to speed approval of generic drugs, but does it address some fundamental flaws in the approval process?
Managed Care March 2008 Martin Sipkoff	PBMs' Rebate Income Threatened By Lawsuits and Move to Generics A recent court settlement may affect the way the PBM industry makes profits, but could it also lead to higher drug costs?
Managed Care December 2005	Pharmacy Cost Increases Below Medical for the First Time in Four Years According to a survey of 70 health care insurers, prescription costs are expected to increase at a lower rate than medical costs during the next 12 months.
CFO June 1, 2010 Alix Stuart	"This Is the Era of Smarter Medicine." A prescription-drug provider says it can thrive even as it helps drive down health-care costs. An interview with Richard Rubino, CFO, Medco Health Solutions Inc.
Managed Care October 2004 Arthur Lazarus	Formulary Restrictions Sometimes Harm Patients Much more research is needed to determine the full effect of drug benefit designs. Quality must be the foremost concern.
The Motley Fool September 27, 2006 Michael P. Cecil	A Drug-Price Avalanche? Wal-Mart shapes the way America buys many products, and its recently announced $4 program for generic prescription drugs may be the harbinger of a major change in prescription-drug sales.
Managed Care January 2004	Increasing drug copayments deter compliance Raising copayments in tiered prescription drug plans increases the likelihood that patients will stop taking prescribed medications, according to a recent study published in the New England Journal of Medicine.
Managed Care March 2008	Drug Caps Lower Spending, but .... These policies tend to make consumers shoulder some of the cost of prescriptions and the cost could be a barrier to medication adherence.
Managed Care September 2003 Tony Berberabe	Pharmacy Benefit Starts To Reflect Push for Consumer-Directed Care Health insurance plans looking for a low-risk way to experiment with new benefit designs might start with the pharmacy benefit.
Managed Care January 2008	Copayment Rates Outpace Inflation Workers are definitely paying more for health benefits today than they were in 2000, especially for prescription drug copayments.