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Mississippi, You’re On My Mind
New research by pharmacy benefit manager Express Scripts has found that the “U.S. wasted $418 billion in 2012 based on bad medication-related decisions, and the impact was most deeply felt in those states that could least afford it.” The Express Scripts analysis looked at pharmacy-related decisions …
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NCPA Endorses Bill to Increase Medicare Drug Costs
With Medicare spending representing a massive and growing part of federal deficits, why would anyone want to increase Medicare costs? But that’s just what new legislation backed by the National Community Pharmacists Association would do. The bill, S. 867, introduced on May 6, 2013, by Senators …
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Forcing Seniors & Disabled People to Pay Higher Prescription Drug Costs
Every once in a while, independent drugstores push a policy argument that leaves us scratching our heads. The NCPA’s latest notion is the idea that Medicare Part D preferred pharmacy networks might threaten access to quality care and threaten the survival of community pharmacies. In …
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Garbage In, Garbage Out: How NOT to Design Survey Research
It’s not often an advocacy group releases quasi-research with findings antithetical to long-held public policy positions, but the National Community Pharmacists Association (NCPA) recently did just that. The NCPA has been hostile to many of the pharmacy benefit management tools that private and public …
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Emerging Threats to Prescription Drug Affordability
A new Business Insurance article details the strategies mid-size businesses are relying upon to mitigate pharmacy costs including increased generic drug utilization, specialty pharmacy utilization programs, value-based insurance design, and narrower pharmacy networks. Taken together, these tools and techniques (along with many others like mail-service …
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TRICARE Beneficiaries: You’ve Got Mail
In a significant victory for nearly 10 million TRICARE beneficiaries, the 2013 Department of Defense authorization bill signed into law on January 2, 2013 moderates pharmacy copayment increases for program enrollees by expanding the use of a lower-cost mail-service pharmacy benefit for many prescriptions. …
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New PA Law May Mean Margin Compression for Retail Pharmacies
Dr. Adam Fein has posted a superb analysis of a recently enacted Pennsylvania law that effectively undermines the mail-service pharmacy option for employer-sponsored coverage purchased through state-regulated health plans. Under the guise of “freedom of choice,” the drugstore lobby has long supported legislation (which we …
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PBM Tools Save $ Millions for New York’s Medicaid Program
In January 2011, the state of New York found itself funding the most expensive Medicaid program in the U.S. while struggling with a budget crisis. At that time, Governor Cuomo created a Medicaid Redesign Team (MRT) with the stated goal of “ending the state’s Medicaid …
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TRICARE Groups Fighting Proposed Pharmacy Copayment Increases
TRICARE beneficiaries are mobilizing to fight proposed pharmacy co-payment increases contained in the Administration’s FY2013 Defense authorization proposal. The proposal – which has the tacit support of Senate Democratic leaders – would double pharmacy co-pays in the coming year and triple them over the next …
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Pennsylvania Legislation Would Reduce Affordable Pharmacy Options for Consumers, Employers
Small employers, brace yourselves for another legislative fight that could increase your prescription drug costs. This time, the battle is taking place in Harrisburg, Pa. The Keystone State’s General Assembly is considering legislation that would prohibit pharmacy benefit managers (PBMs) from incentivizing individuals in fully-insured …
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