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Managed Care July 2004 Maureen Glabman	Wish List: 10 Things You Want From Your PBM One auditor estimates that 3 percent to 10 percent of pharmacy benefit manager (PBM) claims are processed incorrectly -- always in favor of the PBM.
Managed Care June 2002 Jeffry R. Ellis	Third-Party Payers Don't Realize Burdens Placed on Pharmacists PBMs and HMOs, by imposing a workload that doesn't allow enough time for needed functions, seem to want pharmacists to fail, this author asserts.
Managed Care October 2005	Health Plans Pay Less When PBM Owns Mail-Order Pharmacy The ongoing debate on whether health plans pay more for drugs when using a mail-order pharmacy owned by a pharmacy benefits manager (PBM) or when the mail-order pharmacy is not owned by a PBM may be closer to resolution.
Managed Care February 2002 Bob Carlson	Proposal To Regulate Formularies Draws Sharp Difference of Opinion The National Association of Insurance Commissioners has spent two years developing a model. Drug companies like it; health plans don't...
Managed Care July 2000 John Carroll	Physicians Reconsider Taking On Pharmacy Risk They've been burned here in the past, but physicians - and the HMOs that they contract with - may have learned some lessons.
Managed Care August 2001 Patrick Mullen	The Expanding Role of Pharmacists Lobbying in Washington, monitoring state legislation and generally looking out for the interests of pharmacy programs run by health care plans and pharmacy benefit managers, Judith Cahill leads the Academy of Managed Care Pharmacy at an exciting, critical time...
Managed Care June 2003 Thomas Kaye	Mail Order Pharmacy -- Savings or Added Cost? Mail order programs can provide savings, but HMOs need to ensure that they are actually receiving sufficient value.
Managed Care January 2008 Thomas Kaye	Now Is the Time for Pharmacy Performance Incentives We've made strides in increasing the transparency of pricing in the pharmacy supply chain, and now we need to change dispensing behavior.
Managed Care September 2006 Martin Sipkoff	PBMs Raise the Curtain Efforts are under way to find out exactly how pharmacy benefit managers work their magic.
Managed Care December 2003 Tony Berberabe	Why Do FEHBP and Big Unions Excel at Managing Drug Costs? Pharmacy benefit managers can do only so much to keep drug price increases in the single digits. Initiatives instituted by health plans can help in this effort.
Managed Care April 2002 Rhonda Greenapple	HMOs Have Stake in Quelling Anger at Drug Store Counters Dissatisfied customers have a tendency to lash out and not be very discriminating about their targets. Prescription: Reduce the hassle...
Managed Care June 2005	PBMs Get Thumbs up From Satisfied Customers Pharmacy benefit managers that educate physicians on the safety and efficacy of generic drugs or provide them with generic drug samples to increase the use of generics get higher satisfaction ratings than those that don't.
Managed Care January 2001	Express Scripts' Formulary Rulings To Go Online The public will have a chance to see what until now has been, mostly, understood only by managed care insiders: how a prescription drug winds up on a formulary...
Managed Care July 2002 Thomas Kaye	Managing the Drug Benefit: One Company's Experience The pharmacy director of Blue Cross of Oklahoma shares his company's success with using three tiers and coinsurance to promote member responsibility.
Managed Care April 2005 Thomas Morrow	Specialty Pharmacy Meets Niche Company Expertise As new specialty pharmacy care becomes more dominant, companies devoted to managing these products and their associated costs are finding a market.
Managed Care August 2002 Madeleine A. Estabrook	Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.
Managed Care February 2001 T. Jeffrey White	Making Pharmacoeconomics In Formulary Development a Reality Despite what might be commonly believed, pharmacoeconomics is not a widely used tool for formulary development. Here's a model to follow...
The Motley Fool April 19, 2011 Bryan White	Rising Star Buy: Medco Health Medco has a much brighter future than its current stock price implies.
Pharmaceutical Executive May 1, 2011 Mason Tenaglia	Out of Control The pharmaceutical industry needs to use new and better data to accurately measure how much it is willing to invest in avoiding plan control.
Managed Care September 2000	Three New England States Form Drug-Buying Cooperative Now that the governors of Maine, New Hampshire, and Vermont have agreed to form a prescription drug-buying cooperative, the hard work of fleshing out the plan begins...
Managed Care October 2003	Medco Health Solutions tops consumer survey The 2003 WilsonRx Survey reports that patients have identified Medco Health Solutions as the top pharmacy benefit manager for the third year in a row.
Pharmaceutical Executive October 1, 2010	Pharmacies are Our Friends An underutilized sales resource, pharmacies and their staffs can help lead to improved scrip fulfillment and increased business.
Managed Care February 2002 Ira Studin	Reframing the Pharmaceutical Manufacturer/Health Plan Relationship in Managed Care It is suggested that health plans address "total cost-of-care savings" in their budget process, and the pharmaceutical manufacturers establish a "consultative service function" in their managed care divisions...
Managed Care September 2002 John Carroll	When Success Sours: PBMs Under Scrutiny Pharmacy benefit managers are under fire from many corners. What will the push for transparency mean for the industry?
Managed Care March 2008 Martin Sipkoff	PBMs' Rebate Income Threatened By Lawsuits and Move to Generics A recent court settlement may affect the way the PBM industry makes profits, but could it also lead to higher drug costs?
Managed Care April 2002 Paula Sirois	HMOs Should Prepare Now To Get Handle on Injectables With more than 360 biotech products in the pipeline, high-cost injectable drugs are about to flood the market. How will we control the expenditure?
Managed Care April 2005	Small HMO Takes Big Step: Decides To Launch PBM One small health insurer sees an opportunity in the recent woes that pharmacy benefits managers have experienced.
Managed Care October 2001 Patrick Mullen	Interview: Pharmacists in Need The executive vice president and CEO of the American Pharmaceutical Association says pharmacists are being inundated and need help...
Managed Care September 2005 Martin Sipkoff	Mail Order Pharmacy Saves Money, Says PCMA, but at What Cost? The savings to consumers and employers are apparent, but are health plans left holding the bag in mail-order pharmacy?
Managed Care October 2004 Tony Schueth	Formulary Standards Key To E-Prescribing Success Electronic prescribing needs standardization before it's adopted by the masses. Start with the format of formulary databases.
Pharmaceutical Executive February 1, 2014 Jill Wechsler	Drug Coverage, Costs Under Scrutiny Benefits offered by insurance plans on health exchanges and through Medicare are raising concerns about patient access to needed therapies
Managed Care February 2007 Martin Sipkoff	As Drug Payment Model Changes, Confusion Grows Among Insurers Purchasers are hopeful that life after "average wholesale price" will be simpler, fairer, and, with luck, easier to grasp.
Managed Care September 2006 Martin Sipkoff	Specialty Pharmacy Grows As Cost-Control Option As the population ages, specialty pharmacy is becoming a unique, profitable, and invaluable delivery system. Plans are increasingly turning to specialty pharmacies to provide the expertise they lack.
Pharmaceutical Executive October 1, 2008 Chris Biddle	Stop the Bleeding Pharmaceutical manufacturers overpay pharmacy benefit managers millions of dollars each year in rebate overpayments. Here's how to stop the leakage.
Managed Care March 2007 Louis W. Hutchison	Unable to Carry Cost Burden, Payers Seek Other Remedies The pharmacy benefit landscape of today is all but unrecognizable from its predecessor of just a decade ago. Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Managed Care April 2007 MargaretAnn Cross	Do P&T Committees Have Enough Power? Plans and PBMs are divided about sharing drug prices with clinicians. Is it better to have an administrative committee determine the formulary?
Managed Care November 2005 John Carroll	FTC Report Arms PBMs In Battle With Drugstores Congress passed the Medicare Modernization Act allowing pharmacy benefits managers to participate in Medicare Part D.
Managed Care August 2001	Prescription Plan For Medicare Faces Lawsuit President Bush's plan to give prescription discounts to Medicare beneficiaries has created quite a storm...
Managed Care March 2005 MargaretAnn Cross	Transparency Catches Eye In Coalition's Deal With Medco A consortium of employers is paying the pharmacy benefit manager a new administration fee but taking all rebates and discounts.
Managed Care November 2007 Martin Sipkoff	PBMs Agree to Disclose What They Pay for Drugs Pharmacy benefit managers will charge employers a straight administrative fee, rather than make much of their income through deals with the drug industry.
Managed Care July 2001	Compensating the pharmacy services manager One of the positions that Warren Surveys looked at when it tracked the salaries of 266 titles at over 500 HMO and managed care companies was pharmacy services manager...
Managed Care July 2005 Tony Berberabe	Change in Thinking For Pharmacy Benefits in CDHP The difference between the pharmacy benefit in a consumer-directed health plan and a traditional health plan is greater generic drug utilization.
Managed Care April 2006 Martin Sipkoff	Blues Plan's Bold Move Brings Generics Savings Blue Cross & Blue Shield of North Carolina is waiving its copayments for generic drugs in a unique six-month pilot program.
Managed Care November 2004 Tony Berberabe	Military Brings Order To Formulary System Congress told the Department of Defense to create a uniform formulary for all the services, and cover all FDA-approved drugs.
Managed Care December 2000	How To Save Money on Prescriptions There are ways for low-income groups to avoid paying top dollar for prescriptions. Here's one way physicians can educate consumers...
Managed Care July 2001 Bob Carlson	Oregon Attempts To Blaze Trail With 'Reference-Based' Formulary Pharmaceutical makers invest enormous sums in R&D -- but they also reap enormous profits. States are impatient with the appearance that creates...
Inc. September 2007 Bobbie Gossage	How I Did It: Charles Hallberg, Founder and CEO, MemberHealth How Charles Hallberg turned a 13 person company into a $630 million business.
Managed Care May 2007 Martin Sipkoff	Medication Therapy Management May Finally Enter the Mainstream Pharmacies can now take advantage of CPT codes to bill insurers for direct patient care. Will private payers follow Medicare in offering this service?
The Motley Fool October 28, 2010	Our Top Stock Idea Our investing community's latest prime pick -- Medco Health Solutions.
Managed Care December 2005 Martin Sipkoff	Reports Confirm High Value of Step-Therapy Programs Tiered benefit design and mail order pharmacy are useful, but don't overlook this other significant vehicle for savings: step therapy programs.