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.

Stethoscope shaped liked people
Expanded Medicaid program in Michigan found to largely benefit the most vulnerable patients. 

 
pbms
Initiated in Arkansas, Rutledge v. PCMA is set to decide whether states have the authority to regulate pharmacy benefit managers.
 
Regardless of the channel through which a specialty medication is billed and filled, management strategies will be an essential cornerstone to controlling costs.
Multiple pharmacies recently received letters from ESI stating that on behalf of TRICARE and the Defense Health Agency, ESI was recouping money for compound drug claims submitted in 2015.
Stethoscope
A new study found disturbing evidence that black cancer survivors are more likely to face financial hardship on high deductible health plans than their white counterparts.
The pharmaceutical industry is already seeing the immense benefit of AI and machine-learning technology.
According to the investigators, payers and employers are increasingly adopting HDHPs in an effort to control rising health care costs.
A recent qualitative study presented a potential explanation for why health system specialty pharmacies often find it difficult to partner with payers.
Although some of the largest insurers have waived their cost sharing requirements, employer-sponsored “self-insured” health insurance plans are not required to adhere to these waivers.
The intent of the study was to bring awareness to the medical and nonmedical financial hardships of cancer and how they can impact the use of preventive services, since there is little research available to evaluate this topic, according to the study authors.
According to a new study by West Health and Gallup, 88% of US adults support the federal government directly negotiating the price of a COVID-19 treatment with a drug manufacturer upon its availability due to concerns regarding raised drug prices.
Although many hubs offer similar services, no two specialty pharmacy hubs and no two hub programs are entirely alike.