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Managed Care September 2006 Martin Sipkoff	Specialty Pharmacy Grows As Cost-Control Option As the population ages, specialty pharmacy is becoming a unique, profitable, and invaluable delivery system. Plans are increasingly turning to specialty pharmacies to provide the expertise they lack.
Managed Care November 2005	Plans Change Tactics As Costs Keep Rising For Specialty Drugs With specialty drug costs continually increasing, CuraScript expects to see a significant shift in the percentage of plans exclusively classifying specialty drugs under the medical benefit.
Managed Care August 2004 Alan Lotvin	Specialty Pharmacy Presents Unique Set of Challenges Only a small percent of a typical health plan's population takes medicine for conditions outside the generalist's scope. But it's a big portion of the drug bill.
Managed Care August 2007	Managed Care Outlook Specialty drugs increasingly used to treat chronic conditions.
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 April 2002 Paula Sirois	HMOs Should Prepare Now To Get Handle on Injectables With more than 360 biotech products in the pipeline, high-cost injectable drugs are about to flood the market. How will we control the expenditure?
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 September 2005 John Carroll	Plans Struggle for Control of Specialty Pharma Costs Biotech drugs are a quickly growing component of health plan budgets. Here are the latest management techniques.
Managed Care December 2002	M+C meltdown hinders access to medications The fact that health plans are abandoning Medicare+Choice at a slower rate than in previous years doesn't mask the fact that the exodus of plans only exacerbates the problem of lack of pharmaceutical coverage for the elderly.
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 December 2000	AMCP To Test New Guidelines For Formularies The Academy of Managed Care Pharmacy thinks there's a better way for health plans and pharmacy benefit managers to make formulary decisions than by simply looking at line-item budget figures...
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 July 2006	Specialty Anti-Inflammatories See Huge Increase in Utilization Americans spent 34% more for specialty anti-inflammatory agents used to treat rheumatoid arthritis in 2005 than any other specialty drug category.
Managed Care January 2006 Martin Sipkoff	Old Techniques Never Die, Nor Even Fade Away Urged on by employers traumatized by costs, health plans are renewing their interest in prior authorization, but using a lighter hand.
The Motley Fool February 17, 2005 Stephen D. Simpson	Caremark Hits the Mark Again With expectations of higher than 25% growth in 2005, the pharmacy benefits manager looks like it will continue to take care of its investors.
Pharmaceutical Executive October 1, 2010	Pharmacies are Our Friends An underutilized sales resource, pharmacies and their staffs can help lead to improved scrip fulfillment and increased business.
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
The Motley Fool June 2, 2011 Dee Gill	CVS's Improved Performance Begins to Drown Out the Dump-Caremark Chants Is the prognosis for CVS looking up?
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 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 July 2002	Survey predicts more demand for pharmacy precertification Respondents said that their customers -- employers, for the most part -- will want to see more pharmacy precertification.
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.
The Motley Fool July 6, 2007 Mike Cianciolo	Walgreen: The New Deal Maker Walgreen announces its latest acquisition as it tries to keep pace with the competition. Investors, take note.
Managed Care March 2004 Tony Berberabe	Safeguards Against Stockpiling Now Have Global Ramifications Y2K, 9/11, anthrax scares -- these events crystallized the problem of medication stockpiling. How does managed care respond?
Managed Care March 2006 Martin Sipkoff	Introducing an ROI Model For Pharmacy Services The finance department and pharmacy are not speaking the same language. This model might just bridge that divide.
Managed Care June 2006	Medical Directors Cast Wary Eye On Cost of Biologics Given the exploding costs of specialty products and new technologies, MCOs are exercising tighter control over precertification of products and services.
Pharmaceutical Executive March 1, 2013 Desai & Anbil	Specialty Service Programs: Gearing up for Next Generation Technologies Innovation in hub program design for patient scrip data and clinical support services can lead to increased market share in the hotly contested specialty medicine space.
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 February 2005	Biggest increases in specialty drug costs seen in rheumatologic, cancer, and hemophilia agents Medco reports that of the top seven contributors to specialty drug costs, agents for rheumatologic conditions (80.6 percent), cancer (33.2 percent), and hemophilia (28.4 percent) demonstrated the greatest percent change in cost from 2002 to 2003.
Managed Care September 2007 Frank Diamond	Pay for Performance in Pharmacy Is More Theory Than Reality Even if the the goal of pay-for-performance pharmacy programs is unattainable in this country, working toward it might produce interesting experiments in cost efficiency.
CIO September 26, 2013 Stephanie Overby	Big Data Project Cuts Prescription Costs Express Scripts analytics portal helps doctors prescribe more cost-effective medicines.
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 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...
Pharmaceutical Executive October 1, 2005 Jill Van Den Bos	Formulary Additions: The Big Picture Product managers at pharma firms know how fiercely new drugs compete for inclusion on health plans' formularies. An actuarially sound, full-budget-impact model may be out of reach. But companies could express data in units that a health plan can integrate into its own internal actuarial analysis.
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 April 2007 Daniel Y. Patterson	HMO - 21st Century Model The history of HMOs has been one of conflict between plans and physicians. Could global specialty capitation be a better way?
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 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 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?
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 May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.
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.
Pharmaceutical Executive June 9, 2014 Kleinrock & Noor	Pharm Exec's Pharma 50 2014 For those companies in this year's Pharm Exec Top 50, meeting the accelerating market demand for specialty products has become an acute strategic imperative.
The Motley Fool December 21, 2004 Charly Travers	Invest With Fewer Side Effects Averse to risk? Check out these nontraditional drug companies: Biogen Idec... Elan... Salix Pharmaceuticals... Atrix Laboratories... etc.
Managed Care March 2005	ED drugs covered, but managed care unmoved Health care insurers account for the coverage of erectile dysfunction drugs.
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 2005 Ed Silverman	No Easy Fit For Specialty Hospitals Insurers worry that specialty hospitals will ultimately increase costs at nearby community hospitals
Managed Care March 2007	Plans, PBMs Step up Infotech Initiatives Over the next three years, large and small health plans and PBMs that are currently involved in emerging health information technologies are going to focus on increasing disease management programs and on providing personal digital assistants to physicians, according to a report.
Pharmaceutical Executive September 1, 2013 William Looney	Trying to Control Pharma Costs? A key issue for biopharma marketers today is balancing cost and value factors around specialty biologic drugs, particularly those for cancer and other high profile, life altering diseases.
Managed Care July 2003	Tiering Hospitals Pays Off For Calif. Blues Plan Blue Shield of California members are changing utilization patterns as a result of hospital tiering, say company officials. The company is making further changes in its Network Choice program.