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Tips and trends to unlock pharmacy and medical savings.

The Impact of Biosimilars and Generic Alternatives on Specialty Drug Management

The Impact of Biosimilars and Generic Alternatives on Specialty Drug Management

Blog Post Pharmacy Benefits
Contract and Claim Analysis: Helping Fiduciaries Manage Plan Assets Appropriately

Contract and Claim Analysis: Helping Fiduciaries Manage Plan Assets Appropriately

Blog Post Contract Management Data Analytics Pharmacy Benefits Plan Management
2024 Will See Higher than Normal Employer Health Cost Increases – What Actions Can You Take to Control Costs?

2024 Will See Higher than Normal Employer Health Cost Increases – What Actions Can You Take to Control Costs?

Blog Post Pharmacy Benefits Plan Management
Pharmacist: Biosimilar Adoption Impacts Patients and Plans in 2024

Pharmacist: Biosimilar Adoption Impacts Patients and Plans in 2024

Blog Post Pharmacy Benefits Plan Management
Drug Rebates: Impact on Self-Insured Employer Plans

Drug Rebates: Impact on Self-Insured Employer Plans

Blog Post Contract Management Pharmacy Benefits Plan Management
Drug rebates refer to financial agreements between pharmaceutical manufacturers and payers, such as self-insured employer plans or pharmacy benefit managers...
Prescription Cost Management Best Practices: PBM Contract Market Check

Prescription Cost Management Best Practices: PBM Contract Market Check

Blog Post Contract Management
Benefits consultants face significant challenges when managing pharmacy benefit spend for clients. The lengthy process of evaluating Pharmacy Benefit Management...
Navigating the Complex Landscape of Self-Insured Plans: Overcoming Data Challenges

Navigating the Complex Landscape of Self-Insured Plans: Overcoming Data Challenges

Blog Post Contract Management Plan Management
In the ever-evolving healthcare landscape, benefits brokers, consultants, and TPAs face the daunting task of making critical decisions that impact...
Drug Discounts: How They Affect Plan Sponsors

Drug Discounts: How They Affect Plan Sponsors

Blog Post Contract Management
Drug discounts are reductions in the cost of prescription medications as negotiated by pharmaceutical manufacturers and Pharmacy Benefit Managers (PBMs)....
Including Annual Market Check Provisions in Pharmacy Benefit Contracts

Including Annual Market Check Provisions in Pharmacy Benefit Contracts

Blog Post Contract Management
In the ever-evolving healthcare landscape, pharmacy benefits are crucial in ensuring affordable medication access for patients and plans. Pharmacy benefits...
Navigating Drug Shortages: How Employer-Sponsored Health Plans Support Participants

Navigating Drug Shortages: How Employer-Sponsored Health Plans Support Participants

Blog Post Pharmacy Benefits
Drug shortages are at a ten-year high, challenging patients and healthcare providers. These shortages occur when the demand for a particular...
5 Key Metrics to Evaluate Pharmacy Contract Performance

5 Key Metrics to Evaluate Pharmacy Contract Performance

Blog Post Contract Management
Five Metrics to Evaluate Pharmacy Contract Performance Brokers can evaluate pharmacy contract performance by monitoring several key performance indicators (KPIs)...
Drug Exclusions are Affecting Patients and Plans

Drug Exclusions are Affecting Patients and Plans

Blog Post Pharmacy Benefits
The 2023 growth may be small, but drug exclusion lists are still growing for the three largest pharmacy benefit managers...
Benefit Broker Resolution: Avoid Burnout

Benefit Broker Resolution: Avoid Burnout

Blog Post Pharmacy Benefits
Like the rest of American workers, pharmacy benefit brokers are burning out. Rising healthcare and drug costs, ever-changing policies, and...
Save by Switching from High-Cost Generics

Save by Switching from High-Cost Generics

Blog Post Pharmacy Benefits
Switching from an expensive brand-name medication to a lower-cost generic alternative is a proven savings strategy self-insured plan sponsors employ...
Drug Pricing and the Inflation Reduction Act

Drug Pricing and the Inflation Reduction Act

Blog Post Pharmacy Benefits
The passage of the Inflation Reduction Act (IRA) in August 2022 will impact patients, providers, and benefit plan sponsors by...
Interchangeable Biosimilars: Plan and Patient Savings

Interchangeable Biosimilars: Plan and Patient Savings

Blog Post Pharmacy Benefits
Biosimilar drugs are “highly similar to” and have “no clinically meaningful differences” from existing FDA-approved biologics. Currently, there are 38...
Lowering Diabetes Medication Costs with Alternative Strategies

Lowering Diabetes Medication Costs with Alternative Strategies

Blog Post Pharmacy Benefits
One in ten people in the United States has diabetes. $1 in $4 of US healthcare costs is spent caring...
Medical Pharmacy Affects Plan Spend

Medical Pharmacy Affects Plan Spend

Blog Post Medical Benefits
Pharmacy costs get all the press for rising prices; however, brokers and plan sponsors need to consider medical pharmacy if...
RFP Questions You Should be Asking

RFP Questions You Should be Asking

Blog Post Contract Management
When evaluating a PBM contract at renewal or mid-term market check, brokers and plan sponsors should be asking questions. Questions...
Validating Pharmacy Savings Programs

Validating Pharmacy Savings Programs

Blog Post Pharmacy Benefits
Americans spent $328 billion on prescription drugs in 2020, eight percent of total healthcare spend. The rising cost of medications...
Navigating Gene Therapies

Navigating Gene Therapies

Blog Post Pharmacy Benefits
Research on gene-therapies began in 1960 with the hypothesis that introducing DNA sequences into patients' cells could cure genetic disorders....
A Primer on J Codes

A Primer on J Codes

Blog Post Pharmacy Benefits
High-cost prescription drugs have been wreaking havoc on pharmacy plan budgets for over a decade. However, did you know that...
Trends to Follow in 2022

Trends to Follow in 2022

Blog Post Data Analytics
This year saw a post-pandemic return to preventive care, the introduction of several biosimilars, and legislation governing healthcare transparency. However,...
Data and Vendor Fragmentation in Health Benefits

Data and Vendor Fragmentation in Health Benefits

Blog Post Data Analytics
As payors and stakeholders move to more plan-centric health benefits models, fragmentation significantly impedes program efficacy. Point programs added to...
Artificial Intelligence in Pharmacy: Improving Patient Outcomes

Artificial Intelligence in Pharmacy: Improving Patient Outcomes

Blog Post Data Analytics
Artificial Intelligence (AI) in pharmacy refers to automated algorithms that perform tasks traditionally completed by human intelligence. 62% of healthcare...
Covering Specialty Drugs: Medical vs. Pharmacy Channel

Covering Specialty Drugs: Medical vs. Pharmacy Channel

Blog Post Medical Benefits Pharmacy Benefits
For self-insured plan sponsors, specialty drugs represent 33-50% of total pharmacy spend but only account for 1% of total prescription...
Drug Rebates Affect Formulary Management

Drug Rebates Affect Formulary Management

Blog Post Pharmacy Benefits
Formulary management is becoming increasingly important for plan sponsors. As drug prices, especially specialty costs, continue to rise, improving participant...
A Primer on Biosimilars

A Primer on Biosimilars

Blog Post Pharmacy Benefits
It has been 15 years since the widespread adoption of biosimilar medications in the European Union. Ten years later, in...
Improving Medication Adherence

Improving Medication Adherence

Blog Post Data Analytics Pharmacy Benefits
Medication adherence is a longstanding issue within the complex American healthcare system. Made worse by the global pandemic, nonadherence to...
Three Plan Metrics Every Employer Should Be Monitoring

Three Plan Metrics Every Employer Should Be Monitoring

Blog Post Contract Management Data Analytics
60% of employers report that the cost of their current pharmacy plan is unsustainable. Without requesting bids from vendors or...
Achieve Lowest Net Cost with Clinically Driven Formulary

Achieve Lowest Net Cost with Clinically Driven Formulary

Blog Post Pharmacy Benefits
Clinically driven models are creating a buzz across healthcare. A clinically-driven model moves from a volume-based revenue system to a...
Pharmacy: Looking forward to 2021

Pharmacy: Looking forward to 2021

Blog Post Data Analytics
This year has been, in a word, unique. Fortunately, time marches on, and a new year is around the corner....
Transparency Brings Balance to Drug Rebates

Transparency Brings Balance to Drug Rebates

Blog Post Pharmacy Benefits
There are six significant stakeholders in the complex drug distribution system: pharmaceutical manufacturer, plan sponsor, pharmacy, PBM, wholesaler, and patient....
Specialty Drugs: What are they and what (or who) controls costs?

Specialty Drugs: What are they and what (or who) controls costs?

Blog Post Pharmacy Benefits
The cost of prescription medications is rising, but one sub-set of drugs may be disproportionately eating away at financial resources....
Pharmacy Analytics: How to Lead with Data

Pharmacy Analytics: How to Lead with Data

Blog Post Data Analytics
Experts have long predicted the demise of the spreadsheet; information silos, slow turnaround, and incomplete reporting replaced by AI and...
COVID-19 Treatment: Where Are We?

COVID-19 Treatment: Where Are We?

Blog Post Data Analytics
As some states lift stay-at-home orders amid growing numbers of COVID-19 cases, scientists worldwide are working on potential treatments and...
Another COVID-19 side effect: Drug shortages

Another COVID-19 side effect: Drug shortages

Blog Post Data Analytics
Even before COVID-19 wreaked havoc on the United States’ healthcare system, the availability and price of prescription drugs were a...
Creating emergency medication reserves

Creating emergency medication reserves

Blog Post Data Analytics
The severe state of emergency facing our global community has resulted in many of us staying home in a united...
Database searches and spreadsheets are not analytics

Database searches and spreadsheets are not analytics

Blog Post Data Analytics
If you rely on spreadsheets, SQL, or your data team to generate pharmacy plan reports, you are wasting time and...
Who determines drug prices?

Who determines drug prices?

Blog Post Pharmacy Benefits
Along with fireworks, champagne, and resolutions, we rang in 2020 with price increases on hundreds of drugs. New year, same...
Part 2: What is your pharmacy strategy for 2020?

Part 2: What is your pharmacy strategy for 2020?

Blog Post Plan Management
Last month we gave you two strategies, carefully developed by our pharmacy team, that can help you craft a solid...
Part 1: What is your pharmacy strategy for 2020?

Part 1: What is your pharmacy strategy for 2020?

Blog Post Plan Management
Another year has nearly passed with little change in how the pharmacy industry operates. Pharmaceutical companies are still raising drug...
Harness pharmacy data to make better decisions

Harness pharmacy data to make better decisions

Blog Post Data Analytics
Can your broker, benefits department or PBM tell you how your pharmacy dollars are being spent? Are they able to...
Why you should engage doctors to save on drugs

Why you should engage doctors to save on drugs

Blog Post Pharmacy Benefits
Drug prices are bankrupting employers. This isn’t new. A lack of transparency, fuzzy math and back-door deals have overwhelmed the...
Data Analytics: 3 Keys to a Powerful Savings Tool

Data Analytics: 3 Keys to a Powerful Savings Tool

Blog Post Data Analytics
Our dynamic healthcare system is full of “big data” from the information, statistics, and trends of participants, physicians, plans, and...
How Are Your Pharmacy Dollars Being Spent?

How Are Your Pharmacy Dollars Being Spent?

Blog Post Pharmacy Benefits
Everyone is talking about pharmaceutical costs. We all know that prescription drugs are becoming unaffordable for many patients and plans,...
Your Members Need the Right Drug at the Right Dose

Your Members Need the Right Drug at the Right Dose

Blog Post Medical Benefits
Thirty-two million Americans are taking three or more prescription drugs. Of those, 53% are taking the wrong drug or wrong...

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