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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 August 2007	Incentive Formularies Have Minimal Effect A brief look at the effect of changes in drug benefit design on pharmaceutical use and spending.
Managed Care March 2000	Three-tier drug copayments in; closed formularies on way out?
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.
Managed Care November 2002 Frank Diamond	Companies Leaning on Workers in Battle Against Pharmacy Costs A new urgency means that tiered formularies and higher copayments will become even more widespread, a recent survey indicates.
Managed Care November 2002	Tiered formularies: Giving employees more responsibility Experts who say that educating consumers will be the next method used to curb escalating health care costs often point to the success of tiered formularies, which have made patients more aware of the costs of medications.
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 June 2006	More Young Adults Prescribed ADHD Drugs The number of adults ages 20 to 44 prescribed attention deficit hyperactivity disorder medications increased about 140% from 2000 to 2005. This was even faster growth than the 82% reported for children.
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 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 March 2001	Single-source drugs get formulary preference Managed care organizations often place costly new drugs on a formulary's priciest tier, but products for which substitutes do not exist often are made available at lower copayment levels...
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 May 2003 Wayne Miller	Higher Drug Copays Now Might Cause Problems Later The long-term impact of noncompliance must be considered before copayments are increased. This is especially true where chronic conditions are concerned.
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.
Managed Care July 2002 Thomas Kaye	Managing the Drug Benefit: One Company's Experience The pharmacy director of Blue Cross of Oklahoma shares his company's success with using three tiers and coinsurance to promote member responsibility.
Managed Care October 2001	Small businesses use aggressive tactics to keep benefit costs down Small and mid-sized employers (10-999 workers) saw average health-benefit-premium increases of 9.2 percent last year. Marsh Inc. reports that these companies aggressively blunted the effects of fast-rising health care costs...
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 August 2005 Abourjaily et al.	Evaluating the Nondrug Costs of Formulary Coverage Restrictions Substantial nondrug costs result from switching prescribed medications in response to changes in insurance coverage, and many non-reimbursed costs shift to providers and patients.
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 February 25, 2010 Brian Orelli	An Untouched Market Waiting to Be Captured Unfilled prescriptions are a potential boon to drug companies.
Pharmaceutical Executive November 1, 2012 Lauri Mitchell	Who Pays for Specialty Medicines? Providers and patients fish for that delicate balance between access and abandonment.
Managed Care August 2004 MargaretAnn Cross	Employers Take the Lead In Drug Benefit Design Companies test new approaches to funding the pharmacy benefit with the goal of saving money overall.
The Motley Fool March 25, 2011 Brian Orelli	Pfile Pfizer Under "Potential" Researchers reported promising finding from a clinical trial of Pfizer's new drug, CP-870,893, in pancreatic cancer patients in the most recent issue of the journal Science.
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.
BusinessWeek January 21, 2010 John Carey	Making Personalized Medicine Pay Medco and other pharmacy benefit managers say future profits depend on matching drugs to patients based on their genes.
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?
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.
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 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.
Job Journal August 14, 2005 Marty Nemko	Quick Fix: A Confidence Builder Pick up a minor job offer on your way to interviewing with a major employer.
Managed Care December 2003 MargaretAnn Cross	Will New Benefit Design Harm Some Patients? In the past, reducing demand for care by raising patients' costs has resulted in the loss of some needed care. Can we avoid the trap?
Pharmaceutical Executive January 1, 2012 Christopher J. Piazza	Essential Questions for Essential Benefits A key consideration under the Affordable Care Act is how states select plans for drug coverage.
Managed Care November 2001	Drug Discount Cards May Not Be Full Answer A fair number of consumers have turned to discount prescription cards to help pay for medications but the value of these cards is in doubt...
Managed Care February 2001 T. Jeffrey White	Making Pharmacoeconomics In Formulary Development a Reality Despite what might be commonly believed, pharmacoeconomics is not a widely used tool for formulary development. Here's a model to follow...
Managed Care June 2006 Martin Sipkoff	Limiting Access to SSRIs Does More Harm Than Good Despite the higher costs of SSRIs, compared to older antidepressants, limiting members' access can lead to undertreated depression.
Managed Care June 2005	Headlines On Deadline ... Many jobs available to young adults pay little... Prescription medications are getting more difficult to afford...
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 April 2001	Employers easing prescription limitations? Some older medications once viewed by employers as "lifestyle" drugs when making benefit decisions are slowly gaining recognition as important components of primary care...
The Motley Fool February 24, 2011 Brian Orelli	Profit From Personalized Medicine Pfizer's drug works well, but consider these companies instead.
Managed Care July 2005	Cost being equal, consumers prefer older drugs Seven out of 10 consumers would prefer a drug that had been on the market for 10 years or more, compared to a newer drug, even if the copayments were equal. This could be a sign that consumers are more inclined to start using generic medications.
Managed Care February 2002 Bob Carlson	Proposal To Regulate Formularies Draws Sharp Difference of Opinion The National Association of Insurance Commissioners has spent two years developing a model. Drug companies like it; health plans don't...
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 July 2007 Martin Sipkoff	Lowering Copayments Can Improve Quality of Chronic Disease Care Employers and health plans are starting to see the advantage of what has been termed evidence-based benefit design.
Managed Care March 2006	Study: No Need To Burden Consumers To Cut Drug Bill A study by Express Scripts shows that changing the prescription benefit copayments can reduce costs by encouraging more use of generic drugs. All without shifting costs to consumers.
Pharmaceutical Executive October 1, 2006	Sales and Marketing: Where the Buck Stops Pharma's ultimate customer is the employer - the guy who pays the health plan's bill. Here's what he wants to know about drugs.
Managed Care April 2002	Where Employers, Employees Don't See Eye to Eye Hewitt Associates found key differences in employers' and employees' views of health coverage...
Managed Care August 2007	The Formulary Files ARB costs run high in Medicare Part D.
Managed Care November 2003	States exempt psychiatric drugs in some Medicaid programs While states are implementing broad policies to control Medicaid costs, outpatient prescription psychiatric drugs are falling into newly created exemptions, according to a recent survey conducted by the Bazelon Center for Mental Health Law.
Managed Care June 2006	Headlines On Deadline . . . Target is considering eliminating its traditional health insurance plans for employees... The rise in prescription drug spending in 2005 was the lowest it's been in seven years...
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.