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September 26, 2017
Hot Topic
 
In an effort to help reduce the flow of opioids to those at risk of addiction, insurers are balancing the need to reduce pharmacy access while still ensuring availability to those who need the powerful painkillers. Here’s a look at recent developments.
 
The opioid crisis reached a new level of concern when President Donald Trump responded to recommendations from a White House panel chaired by New Jersey Gov. Chris Christie (R) to declare it a national emergency...
From MEDICARE ADVANTAGE NEWS
 
As congressional Republicans seek to repeal and replace the Affordable Care Act, funding of resources to combat the nation’s growing opioid epidemic has become part of the debate among lawmakers...
From MEDICARE ADVANTAGE NEWS
 
The goal of Anthem, Inc.’s Pharmacy Home Program (PHP) is to keep members out of it...
From HEALTH PLAN WEEK
Today's AIS Health Datapoint
 
352,010 ... is the number of people enrolled in Kaiser Permanente Senior Advantage in California, the nation's largest Employer Group Waiver Plan (EGWP).
 
AIS's Medicare and Medicaid Market Data: Enrollment, Premium Rates, Benefit Designs and Strategies of Medicare and Medicaid Plans

Quote of the Day
 
“The formulary started as a clinical tool, but for most PBMs it has really become a vehicle for market share manipulation. While it may deliver some financial value to PBM clients, it is not really a ‘value-based’ approach.”
 
— Josh Golden, area senior vice president at Solid Benefit Guidance (a division of Arthur J. Gallagher & Co.), tells Drug Benefit News he “takes issue” with some PBMs expanding the definition of value-based pricing to include formulary exclusions.
 
 
 

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