Briana Contreras

Joe Boyle shared proactive compliance strategies for PBMs at PBMI 2025, highlighting the need to adapt to evolving regulations for sustainable growth.

PBMs navigate increasing regulatory demands for transparency, as Joe Boyle stressed the need for robust data management and strategic compliance at PBMI 2025.

At the PBMI 2025 Conference, ClearFile president Joe Boyle encouraged PBMs to attend NAIC meetings, stressing that showing up and maintaining relationships with regulators is critical for long-term success.

Health Secretary Robert F. Kennedy Jr. faces bipartisan scrutiny over vaccine policies, Medicare costs and rural healthcare during a Senate hearing.

Employers face rising healthcare costs and specialty drug challenges, prompting a shift towards strategic partnerships with PBMs for better solutions, according to Karen van Caulil, Ph.D., president and CEO of the Florida Alliance for Healthcare Value, who chatted with MHE in the final installment of a two-part video interview.

Employers are demanding more transparency and partnership from pharmacy benefit managers (PBMs), according to Karen van Caulil, Ph.D., president and CEO of the Florida Alliance for Healthcare Value, who spoke with MHE ahead of her remarks at the Pharmacy Benefit Management Institute’s annual meeting in Orlando.

Healthcare organizations face ongoing challenges like burnout and inefficiency, but a shift towards integrated technology and collaboration offers hope for improvement.

COVID-19 reveals significant political polarization in public health, impacting vaccine attitudes and infection concerns among Democrats and Republicans.

Proposed premium increases in the ACA Marketplace for 2026 surge due to rising healthcare costs, specialty drug prices and subsidy uncertainties, according to a recent KFF analysis.

A new study shows Medicare can pay plans more fairly for caring for people from different racial and ethnic backgrounds without breaking the system.

Experts criticize the FDA's narrow COVID-19 vaccine approval, warning it limits access and undermines public health amid rising hospitalization rates.

Humana enhances value-based care for Medicare Advantage members with new partnerships, addressing rising musculoskeletal condition costs and improving patient outcomes.

With healthcare costs climbing, Stuart will lead the nonprofit insurer’s push to keep coverage affordable for 6 million Californians.

Kasey Raetz, Pharm.D., vice president at Express Scripts and a winner of the PBMI Innovator Award, told MHE she takes pride in the role pharmacy benefit managers play in helping patients access needed care while supporting health plans in managing a complex system.

The FDA suspends Ixchiq, the first approved chikungunya vaccine, over safety concerns, impacting its availability in the U.S. market.

While prophylactic treatment is the standard treatment for severe hemophilia, its implementation can be complicated in patients who develop inhibitors

In this second part of a three-part of a video series, Kasey Raetz, Pharm.D., a PBMI Innovator, told MHE about leading the development of EncircleRx, a program that balances patient access, holistic weight loss support and financial protection for health plans amid soaring demand for GLP-1 drugs.

In this final video of a three-part video series, Joshua Fredell, Pharm.D., senior vice president at CVS Caremark and a winner of Managed Healthcare Executive’s PBMI Innovator Award, said most health plans prioritize achieving the lowest net drug costs, whether through rebates, lower list prices or biosimilars.

New research highlights the potential risks of skipping nasogastric tubes after esophageal surgery, suggesting they may reduce anastomotic leak rates.

The 2023-2024 COVID-19 vaccine proves cost-effective, especially for older adults, significantly reducing illness and hospitalizations across all age groups.

GLP-1 receptor agonists show promise in treating hidradenitis suppurativa, offering significant symptom relief and improved quality of life for patients.

In this second video of a three-part series, Joshua Fredell, Pharm.D., senior vice president at CVS Caremark, said innovation in PBMs comes from simplifying pricing, offering flexible benefit designs, and using technology to create a smoother experience for members.

This final part of the three-part video series highlights Sharon Faust of Navitus reflecting on how personal challenges, including her husband’s accident, reshaped her perspective and empowered her to lead boldly in the PBM industry.

Those with hemophilia face heightened risks of depression and anxiety due to pain and joint issues, impacting their overall mental health and quality of life.

HHS reinstates the Task Force on Safer Childhood Vaccines to enhance vaccine safety and oversight amid concerns over recent ACIP changes.

Dupixent shows potential as a treatment for atopic dermatitis, alopecia and vitiligo, targeting shared immune pathways for improved skin health.

Recent research confirms that aluminum in childhood vaccines does not increase the risk of autoimmune, allergic or neurodevelopmental disorders.

Switching to rFVIIIFc significantly reduces bleeding rates and injection frequency for hemophilia A patients, enhancing treatment efficacy and quality of life.

In this second part of a video interview series, it was revealed that Sharon Faust, chief pharmacy officer at Navitus Health Solutions and PBMI Innovator Award winner, works to improve the pharmacy benefit system by promoting transparency, educating others about rules and supporting new business ideas that help patients and use healthcare money wisely.

Hidradenitis suppurativa patients face higher depression and anxiety risks, but biologic treatments may reduce these mental health challenges.