PSG’s PBM Customer Satisfaction Report provides the most in-depth picture of the PBM landscape today, leveraging perspectives taken directly from employer and health plan…
On January 31, the Trump Administration released a proposal that would require pharmacy benefit managers (PBMs) and insurers to pass through 100% of Medicare rebates…
Controlling specialty drug costs and trends takes constant and careful vigilance. Yet many plan sponsors lack the tools or expertise to monitor integrated member…
The United States could face a serious shortage of both primary and specialty care physicians by 2030—up to 120,000, according to research from the Association…
Imagine being prescribed a high-cost medication by a doctor you’ve never met and who has never reviewed your medical records. Sounds a bit far-fetched,…
Specialty drug spend is a constant challenge for nearly all plan sponsors. One significant problem is managing high quantities on claims for specialty drugs…
Price gouging by pharmaceutical companies is an all-too-common problem that makes health plans and their members pay outrageous prices for previously affordable drugs. Perhaps…
Prior authorizations (PA) have long been a bone of contention between healthcare providers and health plans. Physicians typically dislike them; in fact, 92% of…
Prescription fraud, waste, and abuse (FWA) costs consumers and payers hundreds of millions of dollars. According to the Pharmaceutical Care Management Association, typical examples…
CBS News anchor Angela Kennecke last spoke to her daughter on Mother’s Day. Three days later, 21-year-old Emily died from fentanyl poisoning. Ironically, Kennecke had been…
The high cost of specialty drugs to treat inflammatory disorders, cancer, multiple sclerosis, and other serious illnesses continues to be a critical issue for…
The “Big 3” Pharmacy Benefit Managers (OptumRx, Express Scripts, CVS Caremark) released updates to their 2019 formulary exclusions and this year’s changes come with…
