Blog
Tips and trends to unlock pharmacy and medical savings.
Benefit Broker Resolution: Avoid Burnout
Like the rest of American workers, pharmacy benefit brokers are burning out. Rising healthcare and drug costs, ever-changing policies, and transparency wars are adding to the complexity of benefit plan management....
Save by Switching from High-Cost Generics
Switching from an expensive brand-name medication to a lower-cost generic alternative is a proven savings strategy self-insured plan sponsors employ to reduce plan and participant costs. However, plans may miss...
Drug Pricing and the Inflation Reduction Act
The passage of the Inflation Reduction Act (IRA) in August 2022 will impact patients, providers, and benefit plan sponsors by disrupting drug pricing. The IRA allows the Department of Health and Human Services to...
Interchangeable Biosimilars: Plan and Patient Savings
Biosimilar drugs are “highly similar to” and have “no clinically meaningful differences” from existing FDA-approved biologics. Currently, there are 38 biosimilars on the market, giving patients safe, cost-effective...
Lowering Diabetes Medication Costs with Alternative Strategies
One in ten people in the United States has diabetes. $1 in $4 of US healthcare costs is spent caring for people with diabetes, resulting in a 26% increase in the cost of diagnosed diabetes from $245 billion in 2012 to...
Medical Pharmacy Affects Plan Spend
Pharmacy costs get all the press for rising prices; however, brokers and plan sponsors need to consider medical pharmacy if they want a complete picture of plan spend. Medical pharmacy is the management of drugs billed...
RFP Questions You Should be Asking
When evaluating a PBM contract at renewal or mid-term market check, brokers and plan sponsors should be asking questions. Questions that lead to a thorough understanding of their current PBM contract so they can...
Validating Pharmacy Savings Programs
Americans spent $328 billion on prescription drugs in 2020, eight percent of total healthcare spend. The rising cost of medications is motivating employers, especially those who are self-funded, to invest in pharmacy...
Navigating Gene Therapies
Research on gene-therapies began in 1960 with the hypothesis that introducing DNA sequences into patients' cells could cure genetic disorders. Decades of research have made these therapies a reality with current...
A Primer on J Codes
High-cost prescription drugs have been wreaking havoc on pharmacy plan budgets for over a decade. However, did you know that drugs costs also affect medical plan costs? Drugs are billed in either the medical or...
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