Clinical Role - Payer

Pharmacy Times® is a leader in providing the latest clinical updates, patient counseling tools and innovative solutions to payers, pharmacy benefit managers, formulary chairs and directors, managed care directors, quality assurance directors, and Medicaid/Medicare directors.

audit
The pharmacy’s mind-set should be “Let’s solve the problem” rather than being defensive and attempting to “win the argument” with a PBM audit. 
Whether agreeing to an asset purchase or stock purchase in the sale of a pharmacy, the buyer must perform due diligence. 
partner
Clinical education, strong data analytics, and collaboration are the key aspects in providing patient support and access to specialty pharmaceutical manufacturers.
Evidence-based cancer regimens have been shown to result in better outcomes, including longer survival and less toxicity.
 
Medicare
According to Good Day Pharmacy, plans change each year, and the best plan in 2020 may not be the best plan for 2021.
Insulin prices are 8 times higher in the United States than 32 other high-income countries combined.
Specialty
Specialty pharmacies are uniquely positioned to thrive in the era of value-based health care.       
Pharmacy Times® interviewed Nancy Lyons, BSPharm, MBA, CDE, vice president and chief pharmacy officer for Health Mart, and Pete Slone, senior vice president of public affairs for McKesson, on the importance of payment models that reward pharmacists’ commitment to patient services.
During American Pharmacists Month, and as the country uses all available health care resources to address COVID-19, there has never been a better or more important time to grant provider status to pharmacists.
An overview of arrangements that pharmacies enter into that violate the federal anti-kickback statute.
A study published in The Lancet Public Health found that modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to more than $730 billion in health care spending in the United States in 2016. 
340B
Proposed CMS changes could hurt many health systems that are already struggling due to COVID-19 pandemic.