Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.

Biogenerics will not be taking the U.S. marketplace by storm any time soon. Approval of biogenerics is creating a rift between innovators and generic manufacturers and is putting data exclusivity and interchangeability to the test

Pharmacy Benefits Managers (PBMs) have long gotten a bad rap, taking heat for lack of transparency in their dealings with pharmaceutical manufacturers. Some agreements leave health plans in the dark about the true value of their PBMs. Touting benefits, from clinical-based formularies and lower drug costs and to specialty pharmacy benefits and retail networks, may not be enough today to attract business in a competitive marketplace.

When a drug is approved by FDA, there is a large volume of data available for review, but once the drug is being used in the market, new safety data are not as forthcoming, according to Gerald J. Dal Pan, MD, director, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research (CDER), U.S. Food & Drug Administration (FDA).

While your pharmacy benefit program has no doubt been managing utilization for years with core strategies, it's important to review effectiveness often. Below are the proven strategies that payers should analyze frequently in the current market of increasing utilization.

Findings of a study released earlier this year suggest that the average cost of dispensing prescriptions may be higher than the average dispensing fees paid to pharmacies.

If the rate of growth for specialty-drug spending were to continue at 20% a year, it would account for more than 25% of all outpatient pharmacy spending by 2008, as reported in the CuraScript's Specialty Pharmacy Management Guide and Trend Report. The estimated size of the specialty pharmacies market grew to approximately $40 billion in 2005, with projections reaching nearly $75 billion in 2008.

What makes the high cost of a drug worth it? Does the intervention have to save a life? Or prevent the onset of a more expensive condition? Or add six months to patient survival? It's all in the eye of the beholder—whether you are a payer, patient or provider.

As health plans elect to cover a new FDA-approved vaccine that protects girls and women against strains of the human papillomavirus (HPV), parents might wonder if it will be mandated by states as a routine immunization for girls at a certain age.