Briana Contreras

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.

Originally approved earlier this year for multiple inflammatory conditions, including rheumatoid arthritis, giant cell arteritis, juvenile idiopathic arthritis and COVID-19-related inflammation, Avtozma now aligns fully with the FDA-approved indications of its biosimilar, Actemra.

Kasey Raetz, Pharm.D., transitioned from working at a small independent pharmacy to leading product and pharma contracting strategy at Express Scripts, earning a PBMI Innovator Award for her creative solutions in the evolving pharmacy benefit market.

Joshua Fredell, Pharm.D., senior vice president at CVS Caremark and PBMI Innovator Award winner, is calling for a PBM industry focus on making pharmacy experiences more seamless while continuing to keep drug costs affordable.

The FDA's approval of Alhemo (concizumab-mtci) revolutionizes hemophilia treatment, offering a simpler, subcutaneous injection for better bleed control and patient independence.

In his second video interview with Managed Healthcare Executive, PBMI Innovator Award winner David Blair discusses why breaking up traditional pharmacy benefit manager models is key to improving transparency, reducing conflicts of interest and delivering better outcomes.

In a video interview with MHE editors, Sharon Faust, Pharm.D., MBA, senior vice president and chief pharmacy officer at Navitus Health Solutions, shared that while she originally saw herself as a scientist focused on patient care, she found that her skills in problem-solving and critical thinking were a natural fit for the business side of healthcare.

In this final video part of a three-part video interview series, Brian Anderson, MBA, principal and consulting actuary at Milliman, told MHE he sees a more complex picture when it comes to consolidation in the pharmacy benefit manager industry—one that still holds potential for innovation and improvement. Anderson is one of this year's six inaugural winners of Managed Healthcare Executive’s PBMI Innovator Award.

In this second part of a three-part video interview series, Brian Anderson, MBA, a principal and consulting actuary at Milliman, shared his belief that PBM transparency is essential—but he sees risks in how it's being pursued. Anderson is one of this year's six inaugural winners of Managed Healthcare Executive’s PBMI Innovator Award.

In a video interview with MHE editors, Nathan Downhour, Pharm.D., vice president of strategic pharmacy solutions at Prime Therapeutics, said a shift is already underway in the pharmacy benefit market in terms of becoming more transparent and sustainable across the industry.

In a video interview with MHE editors, David Blair, founder, chairman, and CEO of LucyRx, expressed his belief that pharmacists are an underused resource in the U.S. healthcare system, especially at a time when access to primary care is becoming more limited. Blair is one of this year's six inaugural winners of Managed Healthcare Executive’s PBMI Innovator Award.

Medicare Advantage usage trends reveal slight declines in 2023, highlighting critical insights for policymakers amid rising healthcare costs and enrollment shifts.