Reimbursement

Jayne Hornung, chief clinical officer – pharmacy, Managed Markets Insight & Technology, discusses her presentation on potential causes of the slow uptake in digital therapeutics among payers.

Jayson Slotnik, JD, MPH, partner at Health Policy Strategies, discusses his hopes for the future of value-based contracting and the ideal model for pharmacy’s involvement.

Melissa Somma McGivney, PharmD, FCCP, FAPhA, professor and associate dean for community partnerships at the University of Pittsburgh School of Pharmacy, gives a brief overview of the best practices when it comes to billing in a pharmacy.

Amidst the frenzy of blockbuster medicines, the connection between the high price of a drug and how well it works is becoming looser.

Is big pharma overlooking the Goldilocks solutions right under our nose?

New composite pharmacy adherence measure is a major step in developing standard pharmacy performance measures focused on improving patient care.

The increasing economic burden of treatment may impact patient outcomes.

The goal of the financial counselor is to identify available funding for patient care in a timely manner, but the sheer number of resources and variables involved results in a long, tedious process.

More transparent drug pricing could improve patient care.

As some of the nation’s leading pharmaceutical and biotech giants ramp up product development and commercialization, what was once a futuristic concept has become a reality.

Affordability in drug pricing can be addressed by bringing the manufacturer and plan sponsor to negotiate costs and determine fair compensation for product and service providers in the supply chain.

The Build Back Better bill include an authorization for the government to negotiate lower drug prices.

The respondents included dietitians, nurse practitioners, physician assistants, physical therapists, and physicians.

Work closely with insurance companies to relieve financial assistance burdens and prior authorization requirements for patients.

Pharmacy performance measures can support greater patient access to care and services through team-based care and to facilitate value-based contracts between pharmacists and payers.

Lindsay Bealor Greenleaf, MBA, JD, Vice President of ADVI Health, discusses a new poll from the Kaiser Family Foundation that found that 83% of Americans believe the government should be allowed to negotiate lower drug prices, for both those on Medicare and in private insurance plans.

New legislation in New York state seeks to address flaws in prescription drug distribution system.

Although specialty pharmacies may be able to offer some of the services that a hub provider does, a hub can standardize patient and provider support across the network.

Beyond the benefits to the pharmacist profession, granting provider status to pharmacists addresses the larger societal problem of growing physician shortages.

Formulary changes, utilization management, and a lack of transparency upset a lot of members, which hides a lot of good things that pharmacy benefit managers do.

Concepts could be used in payer-pharmacy value-based arrangements.

As specialty drugs move through clinical trials and preparations for commercialization begin, significant attention is warranted to this process considering the massive investments that would have been already made in the product up to this point.

Pharmacy Times spoke with Dr. Trishia Shaw, the Clinical Assistant Professor of Pharmacy Practice at Chicago State University College of Pharmacy, on her presentation at the NPhA conference titled “Who’s your Provider”—Updates in Provider Status for Pharmacists.

As the price tags for therapies coming to market have soared into the hundreds of thousands and even millions on occasion, paying for them has become an ever-greater cause of concern and focus area.

As health care costs rise and cost-sharing increases, treatment-associated expenses will continue to burden patients.