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August 15, 2017

Hot Topic

As the number of genetic tests and the cost associated with the diagnostics continue to rise, insurers are refining coverage policies and insisting on counseling. Here’s a look at recent developments:

Broad Genomic Analysis Allows For More Precise Cancer Care
As knowledge around biomarkers continues to grow, more tests identifying them are hitting the market...
From SPECIALTY PHARMACY NEWS

Plans Pour Money Into Genomic Research But Keep Coverage Options Narrow for Now
Genomic sequencing may well be the future of preventive medicine, but insurers continue to keep the scope of their policies narrow for now...
From HEALTH PLAN WEEK

Health Plan Payment Policies for Genetic Tests Stick to Form Amid Rush of Interest
Genetic counselors have seen two significant spikes in demand for their services recently, both timed to editorials in The New York Times by actress Angelina Jolie...
From HEALTH PLAN WEEK

 
Today's AIS Health Datapoint

3,824,479 ... people are covered by Horizon Blue Cross Blue Shield in New Jersey. Horizon has 46.4% market share in the state.

From THE AIS GUIDE TO BLUE CROSS AND BLUE SHIELD PLANS. (Not affiliated with the Blue Cross and Blue Shield Association or its member companies.)

            The AIS Guide to Blue Cross and Blue Shield Plans is now online!

Quote of the Day

“In this industry, it’s a double-edged sword. You’re not going to make friends all the time….You may be taking profits out of the pockets of PBMs, but saving insurance companies money. You can’t have your cake and eat it too.”

— Tom Borzilleri, CEO of InteliSys Health and former CEO of a PBM, talking about the potential impact of regulatory changes to the 340B drug-discount program.

Click here to read the DRUG BENEFIT NEWS article in which this quote appeared — "Some PBMs May See Major Impact From Proposed 340B Rule’s Cuts" (Free for DBN subscribers; $17 for non-subscribers.)

 
 
 

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