Pharmacy

Americans in 2013 spent a little more on medical services from the prior year, but utilized them less, according to a new report by the Health Care Cost Institute (HCCI).

Confronted with the escalating costs of specialty drugs, payers and PBMs have been employing a variety of strategies in an attempt to limit their financial exposure and improve patient outcomes.

Experts anticipate plans with up to seven levels

Consider physician incentivization

"Pharmacosynchrony” is a new concept rapidly attracting interest

Possible side effects, population vulnerability also concerns

Utilize pharmacy benefit tools and member engagement strategies

Pharmacy benefits managers are paying attention to medications that specifically target children

Identity proofing is often a roadblock

Industry experts question whether the high cost of treatment is beneficial to patients and health plans

Price continues to drive prescription drug trend

Effectively run an oral oncology drug program

Prior authorization only goes so far

Optimize benefit plans to motivate patients to take advantage of cost-effective drugs

Specialty medications accounted for six of the top 10 drugs in exchange claims data

Measures of access to care explained almost half of variation in readmission by county

MCOs experienced a 1.7% overall pharmacy trend in 2013, down from 1.9% in 2012.

Women saved $483 million in 2013 on contraceptives, or $22.44 per fill

Exclusive video of Pfizer's Dave Mouleson the relationship between payers and pharmaceutical manufacturers.

More than 2,000 biomarker tests are available, and the NCCN Biomarkers Compendium contains information designed to support decision-making around the use of such testing in patients with cancer

Costs are more than $14,000 higher in group more likely to abuse opioids

Exclusive video of Edith Rosato, AMCP CEO on the formulary of the future.

In yesterday’s pipeline update, Chris Peterson, PharmD, a director in the Emerging Therapeutics department at Express Scripts, reviewed the trend in FDA approvals and noted several of the key therapeutic areas with recent generics.

Increasing costs, loss of drug exclusivity and crowded drug classes have prompted the need for better outcomes data to ensure optimization of payer resources