Reimbursement

The Pharmacy Times® Reimbursement resource center provides clinical news and articles, information about reimbursement for clinical pharmacy services.

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The estimate is based on a new analysis of out-of-pocket costs for influenza-related hospitalizations in 2018 that were paid by people with Medicare Advantage plans, which are Medicare plans run by private insurance companies.
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Communication plays a critical role in coping strategies around health and financial challenges, according to a recent qualitative study that investigated how people cope with these challenges.
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Across all of the nations studied, investigators found that the United States accounted for 58% of all prescription drug sales but just 24% of the volume.
 
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In order to eradicate HIV, the researchers said increasing health coverage will be essential. Without that, HIV will continue to spread, and individuals will be unaware of their status.
 
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Value-based contracts can lower costs for payers, offer pharmaceutical companies valuable feedback about their therapies, and, ultimately, improve the quality of health care.
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Nonadherence is linked to poor health outcomes, including a decreased quality-of-life, disease progression, and increased hospitalizations.
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The changes, finalized today, are generally effective for the 2022 plan year and will potentially lower enrollee cost sharing on some of the most expensive prescription drugs.
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Katea Ravega, a partner at Quarles and Brady LLP, discussed the recent Supreme Court ruling in Rutledge v. PCMA and what it could mean for the future of states’ legislation around PBMs.
 
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This week on Pharmacy Times, there are a number of important topics that will be covered and posted throughout the week.
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There are many benefits to adopting and integrating new technological methods for hosting pharmacy organization events.
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Supreme Court ruling clears the way for states to pass laws that protect pharmacies from predatory reimbursement practices by PBMs.
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Supreme Court decision establishes that states do have the right to regulate pharmacy benefit managers in managed care organizations.