All posts by Ramiel

Below are a number of cost-control approaches available today that are not working very well: 1. Insurance Carrier Approach Insurance carriers typically see the bigger picture and have the intrinsic motivation to control pharmaceutical costs. Carriers are in a unique position to engage all four constituents in the solution: healthcare providers, pharmaceutical companies, employers and … Continue reading Fixing Specialty Drugs

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Patient assistance programs, whether from drugmakers or charities, aren’t enough to help the growing number of people being prescribed specialty drugs. Efforts to change the situation are coming from many directions. The National Coalition on Health Care — made up of more than 80 medical societies, health care providers, insurers and other groups — has … Continue reading Call for Transparency

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Payers and pharmacy benefit managers (PBMs) are actively looking to manage this class of drugs in order to deal with the increasing specialty drug trend. As a result, they are increasingly employing utilization management programs such as prior authorizations for high-cost, provider-administered injectables and are now starting to drive utilization toward preferred formulary agents through this process. PBMs … Continue reading Implication to Payers and PBM’s

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