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Managed Care January 2007 Martin Sipkoff	Employers Want Plans & PBMs To Push Hard for Generics Health insurers' aggressive stand on members' use of generic drugs can attract new clients, but does it interfere with the physician-patient relationship?
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 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 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 May 2006 John Carroll	Effective Ways To Increase Usage of Generics Generics is one of the few areas where insurance plans can economize effectively. BlueCross & BlueShield of North Carolina is one of many insurers that are changing members' and prescribers' behavior.
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 June 2006 John Carroll	When New Drugs Are Costly, How High to Raise Copays? As some pretty costly, yet very useful, drugs are introduced, will new formulary designs deny access to needy patients?
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 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.
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.
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 November 2005	Plans Change Tactics As Costs Keep Rising For Specialty Drugs With specialty drug costs continually increasing, CuraScript expects to see a significant shift in the percentage of plans exclusively classifying specialty drugs under the medical benefit.
Managed Care September 2007	Income Said To Influence Use of Generics An observational analysis of pharmacy claims collected from 2001 to 2003 finds that where a person lives and the socioeconomic implications of that location have a lot do with his use of generic drugs.
Managed Care December 2001 Steven S. Martin	PBM Industry Today: Who's Managing Drug Costs? Health plans need to take a closer look. HMOs and employers alike will feel increasing pressure to give in to the desires of consumers...
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?
Entrepreneur November 2004 Julie Monahan	Club Meds Fed up with the high cost of prescription drugs, a group of 50 employers from the Fortune 500 are banding together to negotiate a better deal with pharmaceutical companies.
CFO February 22, 2005 Martha E. Mangelsdorf	I Want a New Drug Plan Companies hoping to curb prescription-drug charges are looking at a host of new cost-control measures.
Managed Care August 2001 Steve Perlstein	Four-Tier Approach Injects Consumerism Into Drug Benefit In tying copayments closely to the actual cost of medications, Humana takes a step toward promoting awareness of resource use...
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 November 2005	Recently Introduced Generics Helped Pbm Control Its Costs The top five generic drugs released over the past three years reduced pharmacy spending by 4.8 percent largely due to the timing of the release of generic products to the market.
Managed Care March 2000 Tim Sawyers	Test Prospective PBM Before Signing Contract How to select, then monitor a pharmacy benefit management company, from a consultant and former HMO director of pharmacy services.
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
The Motley Fool November 3, 2010 Brian Orelli	A Generic Prescription for Double-Digit Growth MedcoHealth Solutions has it.
The Motley Fool January 12, 2010 Dayana Yochim	6 Ways to Score Cheap(er) Drugs Stop overpaying for the pills you have to pop with these simple ways to trim your prescription-drug tab.
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 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 October 2004 Martin Sipkoff	Not So Much of a Reach: Let Sick Pay Less for Drugs The idea is radical and simple: Those who need medication the most should pay the least. There is evidence that this is cost-effective.
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 March 2006	Study: No Need To Burden Consumers To Cut Drug Bill A study by Express Scripts shows that changing the prescription benefit copayments can reduce costs by encouraging more use of generic drugs. All without shifting costs to consumers.
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
The Motley Fool September 27, 2006 Michael P. Cecil	A Drug-Price Avalanche? Wal-Mart shapes the way America buys many products, and its recently announced $4 program for generic prescription drugs may be the harbinger of a major change in prescription-drug sales.
Managed Care July 2005	Cost being equal, consumers prefer older drugs Seven out of 10 consumers would prefer a drug that had been on the market for 10 years or more, compared to a newer drug, even if the copayments were equal. This could be a sign that consumers are more inclined to start using generic medications.
Managed Care January 2008	Copayment Rates Outpace Inflation Workers are definitely paying more for health benefits today than they were in 2000, especially for prescription drug copayments.
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.
Managed Care December 2007	Insurers Lean Toward Generic Alternatives More insurers are focusing their attention on a second approach to generic drug management -- generic alternatives, which contain different active ingredients, but have comparable efficacy to brand-name drugs in the same class.
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 March 2008 John Carroll	Should Plans Pay Physicians To Switch Patients to Generics? The AMA calls it a kickback, but the industry sees it as just good practice to give doctors an incentive to get patients on equivalent generics
The Motley Fool July 30, 2009 Brian Orelli	A Good Business Model for Bad Times Some businesses benefit when people are hurting. It's a beautiful time to be a pharmacy benefit manager, since that business model essentially results in them making more money when their customers save money.
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.
The Motley Fool October 18, 2010 Brian Orelli	Pfizer Flexes Its Generic Muscles The pharma giant moves farther into generic drugs.
Pharmaceutical Executive October 1, 2010	Taking a Less-Generic Route to Generics A leading pharmaceutical industry player speaks out on what is fueling success in the sector.
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 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 September 2003 Tony Berberabe	Pharmacy Benefit Starts To Reflect Push for Consumer-Directed Care Health insurance plans looking for a low-risk way to experiment with new benefit designs might start with the pharmacy benefit.
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 December 2005	Pharmacy Cost Increases Below Medical for the First Time in Four Years According to a survey of 70 health care insurers, prescription costs are expected to increase at a lower rate than medical costs during the next 12 months.
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?
Pharmaceutical Executive January 1, 2012 Mason Tenaglia	Letting the Facts Get in the Way An empirical defense of coupons and copay offset programs.
Managed Care September 2005 John Carroll	Plans Struggle for Control of Specialty Pharma Costs Biotech drugs are a quickly growing component of health plan budgets. Here are the latest management techniques.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...