Pharmacy benefit moves away from copayments and toward coinsurance

Managing Directors of L.E.K. Consulting, Joe Johnson, Todd Clark and Brendan Mitchell introduce the innovations happening in pharmacy, more specifically disruptive innovations, and how they affect managed care. The team explained some of the innovations to be on the lookout for in the future, also.

Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.

Specialty drugs are expected to comprise 80% of the FDA approvals this year. Among them are gene therapies for hemophilia A and Duchenne muscular dystrophy priced at between $2 million and $3 million.

Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Josh Benner, founder and CEO of RxAnte, in this latest episode of Tuning In to the C-Suite podcast. In the conversation, Benner addressed the issue of medication misuse among patients based on access, demographics and more, as well as its solutions. The two also talked about the role technology has on the future of pharmacy and how solutions provided through RxAnte can assist plans to improve their CMS Start rating measures.

They are the trendy way to lose weight and payers have been noticing an increase in GLP-1 claims. An analysis of the pharmacy and healthcare claims of a small commercial health plan in Texas documents the growth in the off-label usage of the GLP-1s, such as Ozempic, for weight loss.

The IQVIA vice president sees trouble for generics manufacturers, but painted a bright picture for biosimilars during his keynote address at the annual meeting of the Academy of Managed Care Pharmacy (AMCP).