Pharmacy Benefit Management

From Drug Benefit News - In reporting second-quarter 2016 financial results, both OptumRx and Express Scripts Holding Co. were bullish on the 2017 selling season, but OptumRx reported stronger growth, partially fueled by its Catamaran buy last year (DBN 4/3/15, p. 1). UnitedHealth Group reported July 19 that its OptumRx unit had $15.1 billion in revenues for second-quarter 2016, up 69% from $9.0 billion in the year-ago period. Revenues for the first six months of 2016 were $29.3 billion, up from $17.2 billion for the first half of 2015. Read more

From Specialty Pharmacy News - CMS launched its Oncology Care Model (OCM) on July 1 with 17 health insurers and almost 200 physician group practices. The five-year pilot, which was developed by the Center for Medicare & Medicaid Innovation (CMMI), is focused on providing better quality and more coordinated cancer care for Medicare fee-for-service (FFS) beneficiaries, as well as other payers, but at a lower cost. Read more

Pharmacy Benefit Management Blog

By Lauren Flynn Kelly - April 14, 2016
In the latest squabble between drugstores and PBMs, the National Community Pharmacists Association (NCPA) on April 1 issued a letter to CMS Deputy Director Cynthia Tudor asserting that Medicare Part D plans and PBMs are not complying with a federal requirement to use drug pricing standards that “...
By Angela Maas - March 30, 2016
As high drug prices continue to make headlines and draw congressional ire, hepatitis C drugs and “Mr. Wu-Tang” Martin Shkreli seem to be getting a reprieve as focus turns to the prostate cancer drug Xtandi. On March 28, 12 members of Congress sent a letter to HHS Sec. Sylvia Burwell and Francis...
By Lauren Flynn Kelly - March 4, 2016
Since the introduction of direct-acting antivirals that in clinical trials demonstrated higher sustained virologic response (SVR) rates in hepatitis C patients than ever before, we’ve seen figures on sales, treatment costs, adherence levels, etc. For example, Harvoni (ledipasvir and sofosbuvir) and...

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