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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 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 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?
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 September 2007 John Carroll	Do Out-of-Pocket Payments Put Preventive Care on Hold? Studies by Cigna and Humana challenge some long-held assumptions about high-deductible plans.
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 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.
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 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.
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 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 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 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 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 August 2007	Consumer-Directed Health Plans: Built to Last or Designed to Fail? A point-counterpoint debate about the effect of CDHPs on overall health and health care costs.
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 January 1, 2012 Mason Tenaglia	Letting the Facts Get in the Way An empirical defense of coupons and copay offset programs.
Managed Care September 2004	Cost-Related Underuse of Heart Meds Leads to Cardiac Complications The study is significant because it is the first nationally representative longitudinal study to demonstrate that patients with serious chronic illnesses experience adverse health events when they restrict their use of prescription drugs due to cost.
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 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.
The Motley Fool February 25, 2010 Brian Orelli	An Untouched Market Waiting to Be Captured Unfilled prescriptions are a potential boon to drug companies.
Managed Care February 2007	Study: Copayments do Affect Compliance Managed care decision makers have a powerful tool that affects patient compliance with antihypertensive medications - the copayment level.
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.
Pharmaceutical Executive December 1, 2011 William Looney	The Medicines Adherence Challenge Keeping skittish patients on their medicines ought to be a strategic priority for Big Pharma, but is it? An expert round table examines how best to make progress and agree on some practical steps for incorporation in the campaign agenda.
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.
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.
Pharmaceutical Executive February 1, 2012 Jill Wechsler	Costs and Benefits of Health Reform Will expanded markets and accountable care organizations offset higher rebates, added fees, and closer scrutiny of marketing and prices?
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 October 2005 Martin Sipkoff	Restrictive Formularies May Be Contagious It's the law of unintended consequences: A restrictive drug formulary maintained by a health plan may influence how physicians treat patients unaffiliated with that plan. What does this mean to managed care?
Managed Care November 2006	Primed to Take on Challenges to PBM's This CMO of a pharmacy benefits manager wrestles with some of insurance's most taxing issues. Price, of course. And here come biologics!
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 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?
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.
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
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.
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
Pharmaceutical Executive November 1, 2013	Roundtable on Market Access Market Access is a window on what matters in the real world of soaring patient expectations and crimped payer budgets for innovation.
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 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 May 2007 Rachel M. Renshaw	Keys to Diabetes Control? Patience, Persistence, and Perseverance Careful attention to a comprehensive treatment plan could forestall or prevent the need to add drugs and costs to a patient's regimen.
Managed Care November 2004 Martin Sipkoff	OTC Status for Low-Dose Lovastatin Would Have Widespread Implications The FDA stands poised to approve OTC low-dose statins, following a similar change in United Kingdom.
Managed Care October 2007 Martin Sipkoff	Asheville's Legacy: Pharmacy Moves From Dispensing to Clinical Management It is an idea whose time has finally come: Today's clinical pharmacists are involved in virtually all aspects of medical care.
Pharmaceutical Executive April 1, 2006 Humphrey Taylor	Opinion: Unintended Outcomes for Consumer-Drive Insurance So-called "consumer-driven" health insurance is designed to help informed consumers make better decisions about their medical treatment. But the high deductibles associated with these plans are affecting the end goal.
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.
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.
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 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 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 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...