Another double-digit increase (13.6%) in per member per year cost underscores the need for close monitoring and management of specialty. Successfully partnering with health plans…
Thinking back to one year ago, when writing this commentary on the upcoming 2020 formulary changes, no one could have foreseen the challenges and difficulties…
Understanding the importance of delivering “an effective formulary strategy” to achieve cost containment in these challenging times, CVS has revealed their 2021 formulary changes. While…
Looking toward 2021, OptumRx has announced its formulary changes effective January 1, 2021. These changes will include a combination of downtiers, uptiers, and exclusions with…
Most-Favored-Nation Price for Medicare Back on July 24 of this year, President Trump announced four executive orders taking a variety of approaches to address lowering…
Managing drug cost and trend is like wrangling an octopus—it’s a constant fight to control the various factors that contribute to rising drug prices. These…
To reduce costs, pharmacy benefit managers (PBMs) and plan sponsors often implement utilization management (UM) strategies, such as prior authorizations (PAs) and step therapies, within…
Utilization management (UM) programs are intended to save plan sponsors money and ensure that patients are using the most cost-effective, clinically appropriate medications. However, our…
There is no shortage of news articles outlining the increase in depression and anxiety across the US with the COVID pandemic and social distancing guidelines. Even…