Pharmacy Benefit Management

From Specialty Pharmacy News - The FDA approved the first biosimilar product, Sandoz Inc.’s Zarxio (filgrastim-sndz), earlier this month, and the industry expects more such approvals. So how should payers be preparing for this new class of drugs? In cases such as Zarxio’s in which the FDA grants indication extrapolation for a biosimilar (see story, p. 1), “Payers need to be really thinking through what it means for their commercial opportunities,” says Gillian Woollett, M.A., D.Phil., senior vice president and head of the FDA Practice at Avalere Health LLC. Read more

From Specialty Pharmacy News - BlueCross BlueShield of Tennessee Inc. (BCBST) is working with Tennessee Oncology, PLLC on a six-month pilot program that’s focused on improving the coordination of care and outcomes for people with cancer. The plan says that “the pilot should lead to better symptom management, fewer emergency room visits and fewer unnecessary treatments.” BCBST members, it says, “will also have 24/7 access to a team of care coordinators trained to help manage their… Read more

Pharmacy Benefit Management Blog

By Lauren Flynn Kelly - March 19, 2015
With the approval of the first U.S. biosimilar through the Biologics Price Competition and Innovation Act and others to follow, it’s an exciting time in pharmacy benefit management. Plan sponsors and PBMs have been anxiously awaiting the arrival of these specialty agents for their potential to save...
By Angela Maas - February 25, 2015
In the midst of continuing conversations over high drug prices, a California state assemblyman has introduced a bill to find out the reasons for them. David Chiu (D) recently introduced AB 463, which would require the manufacturer of a drug with a wholesale acquisition cost (WAC) of more than $10,...
By Lauren Flynn Kelly - February 13, 2015
A new lawsuit brought by a coalition of independent pharmacies points the finger at Catamaran Corp. for allegedly setting unsustainable reimbursement rates that the pharmacies aren’t made aware of until the time of claims adjudication. The complaint, filed Feb. 9 in the U.S. District Court for the...

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