Jan Berger, MD, MJ

The distribution of infusible specialty medications comes with difficulties that must be addressed by pharmacies and payers.

The pharmacy benefit has begun to attract greater attention due to the increase in medications that are available and their cost. It is time we refocus on the needs of the patient and push ourselves and the benefit managers to evolve into a single integrated management and distribution model.

In addition to having a major impact on patient health outcomes, medications can have significant cost implications for all stakeholders; insurers and employers need to work with their pharmacy benefit managers to ensure that the right patients are getting the right medications at the right time.

In our quest to identify the areas and activities that show the greatest positive impact and value in care and outcomes, we must aim to not let good science and evidence get away from us, particularly when considering vaccination.

Specialty-focused partial-fill plan designs are gaining traction, with conflicting opinions on whether they reduce waste or impact the quality of care.

New high cost specialty medications are increasingly treating otherwise untreatable conditions, creating a series of challenges for stakeholders across the healthcare landscape.

Pain medication misuse in no longer just a medical issue alone, as payers need to consider their role and the actions they can take to address this problem.

Without the use of comparative effectiveness as a strong part of the care decision-making process, we will never reach the goal of value-based care.

Although the focus in drug trends has primarily been on unit cost, it is time we look at the other factors involved, including value and quality of life.

Executive-level pharmacy leaders in US managed care organizations identify how healthcare reform is driving changes in pharmacy benefit management.