Member: RADAR on Drug Benefits

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Will New Ways to Finance Costly Drugs Satisfy Employers?

September 12, 2019

With concerns mounting about how health plan sponsors will pay for breakthrough treatments with ultra-high price tags, some major insurers are offering up new solutions aimed at easing that burden.

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Health Plans Wait for More Data on New Narcolepsy Medicines

with Chart: Current Market Access to Narcolepsy Medications

September 12, 2019

Two newly approved narcolepsy medications offer novel, possibly more effective options to people for whom older medications aren’t working well, but most plans are requiring patients and providers to try generic alternatives first.

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Part D Redesign May Not Hit Plan Sponsors Too Hard

with Chart: Effects of Part D Redesign Proposals Vary by Payer

September 12, 2019

While some of the options on the table for redesigning Medicare Part D would place a lot more financial risk onto plan sponsors, there are reasons to believe that the consequences of such a shift might not be that severe.

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Magellan Touts Adherence in Specialty One-on-One Coaching

September 12, 2019

Magellan Rx Management says that members who use its MRx Specialty Pharmacy are significantly more likely to reach and maintain adherence goals of 85% or greater, in large part due to motivational coaching from nurses. But one industry expert says he would want to see more data before reaching conclusions about the program’s effectiveness.

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News Briefs

September 12, 2019

Thus far in 2019, 33 states have enacted a record 51 laws to address drug prices, affordability and access — beating the previous record of 45 laws enacted in 28 states set last year. That’s according to a Kaiser Health News (KHN) article citing data from the National Academy for State Health Policy, which notes that the measures include ones that establish drug-price oversight boards, authorize importing prescription drugs and ban “gag clauses” in PBM contracts. “Both Democrat and Republican leaders have shown a willingness to pursue strong measures that help consumers but also protect state taxpayer dollars,” Hemi Tewarson, director of the National Governors Association’s health programs, told KHN. Read more at https://bit.ly/2kzHcfn.

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