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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?
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 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.
Pharmaceutical Executive August 1, 2005 Kevin Barnett	Part D Phase 2 Pharmaceuticals have been scrambling to get their Medicare contracting in order. Now it's time to figure out part D marketing and sales. Here's a checklist for the months ahead.
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.
Managed Care September 2006 Martin Sipkoff	PBMs Raise the Curtain Efforts are under way to find out exactly how pharmacy benefit managers work their magic.
Pharmaceutical Executive April 1, 2007 Jill Wechsler	Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices.
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 August 2002 Madeleine A. Estabrook	Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.
Pharmaceutical Executive February 1, 2009 Jill Wechsler	Securing Savings A close look at the healthcare industry will separate real cost-cutting measures from money-saving myths.
Managed Care December 2001 Steven S. Martin	PBM Industry Today: Who's Managing Drug Costs? Health plans need to take a closer look. HMOs and employers alike will feel increasing pressure to give in to the desires of consumers...
Pharmaceutical Executive November 1, 2006	Roundtable: Deficit Reduction Act As things stand today, the most disruptive, confusing, and impossible-to-comply-with regulations for pharma marketing will be the ones springing from the Deficit Reduction Act of 2005, signed into law by President Bush this past February.
Managed Care March 2005 MargaretAnn Cross	Transparency Catches Eye In Coalition's Deal With Medco A consortium of employers is paying the pharmacy benefit manager a new administration fee but taking all rebates and discounts.
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 November 2005 John Carroll	FTC Report Arms PBMs In Battle With Drugstores Congress passed the Medicare Modernization Act allowing pharmacy benefits managers to participate in Medicare Part D.
Pharmaceutical Executive December 1, 2008 Jill Wechsler	Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers.
Pharmaceutical Executive May 1, 2006 Huang, Pesile & Mozeson	Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster.
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 October 2005	Health Plans Pay Less When PBM Owns Mail-Order Pharmacy The ongoing debate on whether health plans pay more for drugs when using a mail-order pharmacy owned by a pharmacy benefits manager (PBM) or when the mail-order pharmacy is not owned by a PBM may be closer to resolution.
Pharmaceutical Executive December 1, 2006 Rod Cavin	Forecasting Medicare: Price Controls in the Years Ahead Part D in 2010 will be under price and access pressure. Pharma should develop plans for the future by imagining best- and worst-case scenarios.
Pharmaceutical Executive July 1, 2005 Jill Wechsler	Washington Report: The e-Bandwagon The federal government is driving e-Rx adoption by establishing standards that Medicare drug plans will have to adopt by 2009, and HHS officials are pushing to make this happen much earlier.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
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 November 1, 2005 Patrick Clinton	Are We Aligned Yet? A Medicare Part D Roundtable The most salient feature of the Medicare prescription drug benefit is its uncertainties.
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
Pharmaceutical Executive September 1, 2005 Tenaglia & Angelastro	No Margin for Error Pharmaceutical companies that will be forced to cut back on sales and marketing spending must focus on value, not volume. Here's how to reduce your spending where it matters the least.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
The Motley Fool January 22, 2007 Michael P. Cecil	Will Medicare Negotiate With Drug Companies? One of the bedrock principles of our economic system is that those buying more of a product receive a discount. Wouldn't empowering Medicare to save taxpayers' money be widely embraced as a great idea? But how would pharma investors see it?
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.
Pharmaceutical Executive January 1, 2013 Jill Wechsler	Transformation to Characterize 2013 FDA policies will reshape drug development, while pressure to cut healthcare spending may alter drug coverage and pricing.
Managed Care November 2007 Martin Sipkoff	PBMs Agree to Disclose What They Pay for Drugs Pharmacy benefit managers will charge employers a straight administrative fee, rather than make much of their income through deals with the drug industry.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Managed Care December 2000 Michael D. Dalzell	Prescription Drug Reimportation: Panacea or Problem? Health plans concerned about the cost of pharmacy benefits might want to look at potential effects of prescription drug reimportation -- formulary issues and legal questions, to name two -- even if full implementation is a while off...
OCC Bulletin May 30, 2000	Risk Modeling This bulletin provides guidance to help financial institutions mitigate potential risks arising from reliance on computer-based financial models that are improperly validated or tested...
Managed Care February 2006 Martin Sipkoff	Don't Bet That Problems With Part D Are Over Medicare Part D enrollment snags could be just the start of political and regulatory headaches facing health plans and pharmacy benefit managers.
Pharmaceutical Executive October 1, 2011 Jill Wechsler	An 'A' for Advancing Expectations As head of both the Food and Drug Administration and the Centers for Medicare and Medicaid Services, Mark McClellan has been at the center of public policy affecting the pharmaceutical industry over the last decade.
The Motley Fool December 29, 2005 Brian Gorman	PBMs at a Crossroads One prediction that's sure to come true next year -- drug prices will rise. Pharmacy benefit management (PBM) companies will respond. But the year ahead promises to be trickier for investors seeking to profit from PBMs.
Managed Care December 2000 Bob Carlson	3 New England States Prescribe Innovative Ways To Cut Drug Prices It's too soon to tell whether Maine's prescription drug price control law will survive a legal challenge by drug makers. But private efforts and another innovative strategy -- a plan by Maine, Vermont, and New Hampshire to purchase prescription drugs jointly -- are moving ahead...
Managed Care November 2004 John Carroll	Medicare Formulary Model Seen by Many as Too Inclusive The issue is how extensive the list of covered medications should be for the new Medicare pharmaceutical benefit. The stakes are enormous.
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 December 2000	How To Save Money on Prescriptions There are ways for low-income groups to avoid paying top dollar for prescriptions. Here's one way physicians can educate consumers...
Pharmaceutical Executive May 1, 2005 Erik Felker	Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage.
Managed Care December 2004	Number of Prescriptions Grows Faster Than Population With the rising costs of prescriptions and other issues relating to implementation of the new Medicare drug benefit, it is no wonder that policymakers are considering new approaches to addressing drug costs.
Managed Care August 2001 Patrick Mullen	The Expanding Role of Pharmacists Lobbying in Washington, monitoring state legislation and generally looking out for the interests of pharmacy programs run by health care plans and pharmacy benefit managers, Judith Cahill leads the Academy of Managed Care Pharmacy at an exciting, critical time...
CFO February 22, 2005 Martha E. Mangelsdorf	I Want a New Drug Plan Companies hoping to curb prescription-drug charges are looking at a host of new cost-control measures.
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.
Pharmaceutical Executive June 1, 2011 Zhang & Dubman	To Genzyme, Quality Data Depends on Quality Governance The payoff is superior performance in key areas such as clinical trials
The Motley Fool June 17, 2004 Seth Jayson	Big Business vs. Big Pharma An organization of human resources executives from companies that employ 12% of the private sector U.S. workforce is working to create a prescription drug "buyer's club," with the help of HR management firm Hewitt Associates.
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