Drug costs

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Opioids are powerful clinical tools that effectively treat pain and have a place in therapy, but it can be difficult to manage the dangers. Here's a look at some of the abuse-deterrent drugs on the horizon.

Prime Therapeutics has studied the costs and clinical events relationship among their members using a controlled substances (CS) score algorithm that identifies potential overuse/abuse of opioids/controlled substances.

In this Q&A, a presenter at the upcoming ASH conference discusses new hematology payment models and the top challenges payers face in this area.

FDA’s approval of Vertex Pharmaceutical’s groundbreaking lumacaftor/ivacaftor (Orkambi) for cystic fibrosis (CF) is the first drug to treat the underlying cause of CF in people ages 12 and older with two copies of the F508del mutation.

FDA’s approval of the first generic version of Copaxone for treating patients with relapsing forms of multiple sclerosis has industry insiders contemplating the impact on the generics market as well as payer coverage strategies.

Consensus is building on the promise of genetic testing and other technological advances to help individualize testing, prevention and treatment for better outcomes.

Health plans struggling to rein in pharmacy costs are using mail service, disease management programs, financial incentives for generics, member cost sharing, and, increasingly, limited and closed formularies.

Two recent studies show that members who obtain health insurance through state or federal insurance exchanges use more specialty and generic drugs than their counterparts in commercial plans.

espite the fact that approximately 2.74 million patients used anti-obesity drugs in 2011, according to information services company IMS Health, the majority of health plans are following the lead of the Centers for Medicare and Medicaid Services and not covering them.