Spending growth for specialty drugs rose 19.6% between 2009 and 2010, while growth of traditional drugs decreased by 1.4%, according to Express Scripts' 2010 Drug Specialty Report. Payers are struggling to appropriately manage high-cost drugs while ensuring their members get the care they need. One strategy is introducing a specialty drug tier to the formulary, which raises a red flag on access issues.
Providers and payers appear to be moving steadily toward an accountable-care model of healthcare delivery, and competitive markets influence the development.
Advocates for community-based plans are driving the message that they can and do provide value.
ACOs will be expected to have accreditation as a minimum standard.
While the politicians campaign, the federal government will continue to roll out the programs created by the Patient Protection and Affordable Care Act
Most top-quality health plans in the U.S. are offered by nonprofit organizations, says Bruce McPherson, president and CEO of Alliance for Advancing Nonprofit Health Care. He bases that claim on 2011 rankings recently released by the National Committee for Quality Assurance (NCQA)
Cancer drives healthcare costs - to the tune of $124 billion on cancer drugs in 2010 alone - according to Medco, a pharmacy benefit manager. But nutritional counseling of cancer patients is often ignored, even though by some estimates most cancer patients will develop clinical malnutrition.
Nearly a third of the Medicare population is obese, which leads to more serious health problems that are expensive to treat. The Centers for Medicare & Medicaid Services (CMS) have decided to cover obesity screening and counseling as a preventative measure, but are primary care physicians equipped to provide such services?
Prime Therapeutics (Prime) will administer pharmacy benefits for Blue Cross and Blue Shield of North Carolina (BCBSNC) commercial customers staring in April next year. The companies say the move will result in lower pharmacy costs for BCBSNC customers and more flexibility regarding services and programs.
The 12th Asian Conference on Clinical Pharmacy will be held July 7-9, 2012, at the Hong Kong Convention and Exhibition Centre.
FDA’s Vaccines and Related Biologics Advisory Committee recently voted in favor of expanding the indication for the pneumococcal 13-valent conjugate vaccine (Prevnar 13) for the prevention of pneumococcal disease in adults age 50 years and older, Pfizer Inc, the drug’s manufacturer, said in a statement.
FDA approved the first generic version of the cholesterol-lowering drug Lipitor (atorvastatin calcium tablets).
Hospital systems are partnering with church and community-based organizations to extend their reach into neighborhoods where access can might be problematic.
Industry experts say although it seems early for states to establish insurance exchanges, they shouldn't risk waiting too long.
Switching patients from intravenous drugs to pill forms of the same drugs could safely save millions
The U.S. Preventive Services Task Force (USPSTF) is no longer recommending the prostate-specific antigen (PSA) screening test for healthy men
Lower utilization and steady service costs bode well for managed care overall.
Patient-centered medical homes (PCMHs) are gaining traction with increasing support from health plans, based on their promise to lower costs.
Private exchanges are moving aggressively to address the challenges of providing quality healthcare at an affordable price, according to experts.
It is important to consider the impact the federally mandated coverage provisions might have on enrollment.
When it comes to predicting geographic variations in cost, what's true for Medicare doesn't necessarily hold for the commercial populations.
Patient privacy remains a key issue for health plans, according to a new survey conducted by PricewaterhouseCoopers (PwC).
As expected, the Supreme Court will decide if key provisions of the healthcare overhaul law violate the Constitution.
Paying for performance will cause many health plans to rethink how they contract with provider networks, and experts say there are tremendous changes ahead.
While health plans might point to legislation and expansion of public programs as a hindrance, an increase in administrative services only (ASO) arrangements is taking a bite out of the business as well
The advent of ACOs will reshape healthcare delivery, however, the commercial market is positioned to drive the revolution much faster.
To fight the rising cost of healthcare, some companies are cutting back but, it doesn't help employees become healthier.
FDA has changed the label for fenofibric acid (Trilipix, Abbott). It now carries a warning that the agent may not lower the risk of myocardial infarction or stroke.
All children and adolescents should be screened for high cholesterol, and children as young as aged 10 should be considered for treatment with statins, according to the latest update from an expert panel convened by the National Heart, Lung, and Blood Institute.
The American Heart Association and American College of Cardiology Foundation have issued new guidelines for secondary prevention and risk reduction in patients with atherosclerotic vascular disease.