MHE June 2023

PBMs have imposed accumulators and maximizers to counteract pharma’s copay assistance programs. Drug manufacturers have retaliated by reducing the amount of patient assistance available.

Virtual care presents a unique opportunity to achieve the kind of whole-person care that has been discussed in healthcare for decades, if not longer.

Insurers are using prior authorization and other managed care strategies to control costs associated with the growing number of prescriptions, on- and off-label, for the weight-loss medications.

Experts say the successes and failures of alternative payment models (APMs) over the past decade have taught us a few things.

Alternative payment models are still coming into focus, but so far, they haven’t lived up to the high expectations.

The company paved the way for prescription digital therapeutics.

Ocaliva and resmetirom may be approved by the FDA this year.