Pharmacy Benefit Management

From Drug Benefit News - One health plan recently added clinical case management pharmacists to its care management teams with an eye on offering an extra level of care to its members. Highmark Inc. says that the new additions will provide members with a range of services to better manage their health care needs, including helping to prevent medication errors. Read more

From Drug Benefit News - When Florida overhauled its Medicaid program in 2011, one of the changes required managed care companies participating in Florida’s Medicaid managed care program to use a state-mandated preferred drug list (PDL) instead of their own formularies. And although proponents of the legislation claimed that it would help hold down costs in the program, a recent study shows that drug costs actually increased after the PDL requirement was implemented in July… 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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