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…
The high cost of specialty drugs to treat inflammatory disorders, cancer, multiple sclerosis, and other serious illnesses continues to be a critical issue for plan…
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…
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…