Specialty drug spend is a constant challenge for nearly all plan sponsors. One significant problem is managing high quantities on claims for specialty drugs covered…
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 the…
Prior authorizations (PA) have long been a bone of contention between healthcare providers and health plans. Physicians typically dislike them; in fact, 92% of respondents…
Prescription fraud, waste, and abuse (FWA) costs consumers and payers hundreds of millions of dollars. According to the Pharmaceutical Care Management Association, typical examples of…
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 working…
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 expansion…
Nobody is immune from the effects of opioid misuse. A tragic number succumb to fatal overdoses—one every 13 minutes. Addiction also leaves its mark on…
Recently it was announced that Regeneron and Sanofi had entered into an agreement with Express Scripts to drastically reduce the price tag on Praulent, a…
Understanding Why Cost Concerns Continue For the last 7 years, PSG’s Pharmacy Benefit Management Institute (PBMI) has produced original research focused on specialty drug benefit…