-
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 …
Read More -
Health Care Fraud Costs Everyone
Without a doubt, our nation’s health care system faces an array of challenges related to quality, affordability, and access. Given the breadth of our challenges, it makes the prevalence of fraud, waste, and abuse in our system that much more frustrating and galling. Depending on …
Read More -
New Report Details Potential Medicaid Savings from Using PBM Tools
In addition to offering significant savings for private health insurers, pharmacy benefit management (PBM) tools could save the Federal government and state governments $74.4 billion in Medicaid costs over ten years according to a new report by the Menges Group prepared for the Pharmaceutical Care …
Read More -
A Look At Drug Spending Trends and the Impact of Pharmacy Benefit Management Tools
The release by Express Scripts of its 2012 Drug Trend Report gives us an opportunity to look at trends in drug spending in the United States. Here is the press release announcing the new drug trend report. First the good news. Among the commercially insured population, …
Read More -
Wall St. Journal and Academic Look at Adverse Effects of Independent Pharmacy Efforts to Get PBM Pricing Data
A Wall Street Journal article, “Drugstores Press for Pricing Data,” (Mar. 27, 2013) takes a close look at independent pharmacy lobby efforts to get new laws in Oregon and other states forcing pharmacy benefit managers (PBMs) to turn over to pharmacies sensitive pricing information. The …
Read More -
Good vs. Bad Regulation
There are times when enhanced government regulation in health care is desperately needed to protect the public and to restore trust and confidence in certain parts of the system. The recent, tragic case of a Massachusetts compounding pharmacy effectively acting like a drug manufacturer – …
Read More -
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 …
Read More -
CVS Caremark Drops Coverage of 17 Prescriptions from 2013 Standard Formulary
CVS Caremark’s PBM unit has announced plans to drop coverage of 17 prescription drugs from its standard formulary beginning January 1, 2013, the Wall Street Journal reported recently. The PBM’s standard formulary is the one selected by most of its employer clients, but the decision …
Read More -
New Report Highlights Growing Price Disparity Between Brand-Name and Generic Drugs
Pharmacy benefit manager Express Scripts has just released its first Drug Trend Quarterly. With this report, the company is transitioning its prior annual Drug Trend Report to a quarterly publication that will provide fresher data. The report now combines Express Scripts data with data from …
Read More -
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 …
Read More