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Managed Care June 2005 Martin Sipkoff	MMA Formulary Design Requires Health Plans To Control Costs Despite a mandate to adopt utilization management programs and make patients share costs, health plans are still lining up to participate in Medicare Part D.
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 June 1, 2006 Roger Williams	Setting the Standard United States Pharmacopeia's CEO offers some straight talk about how the organization is changing its role from a facilitator of quality to the engine driving it.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
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...
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 June 2006 Martin Sipkoff	Limiting Access to SSRIs Does More Harm Than Good Despite the higher costs of SSRIs, compared to older antidepressants, limiting members' access can lead to undertreated depression.
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 May 2005	Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.
Managed Care February 2007 Martin Sipkoff	What's Good for the VHA Is Not So Good for Medicare Fundamental differences in program structure between Medicare and the Veterans Health Administration make drug pricing negotiations problematic.
Managed Care April 2004 John Carroll	$50M for Drug Comparisons Could Produce Valuable Results The Medicare amendment adopted late last year contains a provision that could help P&T committees, not to mention consumers, evaluate competing drugs.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
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...
Pharmaceutical Executive February 1, 2007 Patrick Clinton	From the Editor: Meaningless A bill requiring the Secretary of Health and Human Services to negotiate Medicare drug prices directly with pharmaceutical manufacturers has a fatal flaw.
Pharmaceutical Executive December 1, 2008 Jill Wechsler	Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers.
Managed Care December 2006 Martin Sipkoff	Federally Negotiated Drug Prices Anticipated for Medicare Part D Congress to force the issue of federally negotiated drug prices. This could eventually lead to a government-run drug plan.
Managed Care February 2006	For Drugs, the VA Pays Far Less Than Medicare A recent survey indicates that prices for the top 20 drugs used by Medicare enrollees are much higher than prices negotiated by the Department of Veterans Affairs.
Managed Care March 2005	ED drugs covered, but managed care unmoved Health care insurers account for the coverage of erectile dysfunction drugs.
Pharmaceutical Executive December 1, 2006 Rod Cavin	Forecasting Medicare: Price Controls in the Years Ahead Part D in 2010 will be under price and access pressure. Pharma should develop plans for the future by imagining best- and worst-case scenarios.
The Motley Fool January 22, 2007 Michael P. Cecil	Will Medicare Negotiate With Drug Companies? One of the bedrock principles of our economic system is that those buying more of a product receive a discount. Wouldn't empowering Medicare to save taxpayers' money be widely embraced as a great idea? But how would pharma investors see it?
Managed Care January 2008 John Carroll	Plans Look Askance at Me-Too Medications Tougher standards being applied by insurers spur debate about what constitutes true value in a new drug.
Managed Care December 2001 MargaretAnn Cross	Increased Pressures Change P&T Committee Makeup Formulary committees once were stocked with academics and administrators. Today, primary care physicians, specialists, and retail pharmacists play a bigger role, and tomorrow's membership will be even more diverse...
The Motley Fool February 25, 2010 Brian Orelli	An Untouched Market Waiting to Be Captured Unfilled prescriptions are a potential boon to drug companies.
Managed Care March 2006 David Adler	Tiers Reach New Heights Under Part D Can commercial health plans learn from Medicare Advantage Prescription Drug Plans that have four or more formulary levels?
Managed Care April 2001 Jack McCain	System Helps P&T Committees Get Pharmacoeconomic Data They Need The Academy of Managed Care Pharmacy is testing a plan to have drugmakers submit evidence-based outcomes analyses when seeking formulary inclusion...
Pharmaceutical Executive May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.
Managed Care December 2000	AMCP To Test New Guidelines For Formularies The Academy of Managed Care Pharmacy thinks there's a better way for health plans and pharmacy benefit managers to make formulary decisions than by simply looking at line-item budget figures...
Managed Care March 2008	PDP Drug Restrictions Block Comparison Shopping A review of 169 commonly used drugs covered by Medicare Prescription Drug Plans (PDPs) reveals that only 4 of the 10 largest plans by enrollment have all of those 169 drugs on formulary.
Pharmaceutical Executive February 1, 2009 Jill Wechsler	Securing Savings A close look at the healthcare industry will separate real cost-cutting measures from money-saving myths.
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
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.
Pharmaceutical Executive August 1, 2005 Kevin Barnett	Part D Phase 2 Pharmaceuticals have been scrambling to get their Medicare contracting in order. Now it's time to figure out part D marketing and sales. Here's a checklist for the months ahead.
Managed Care September 2003 Thomas Morrow	Managed Care Strategy: Create Competition In Expanding Biotech Field The biotech field is booming, and insurers are scrambling to find ways to deal with the high costs of new "biologic" treatments. One strategy is to try to create more competition among the producers of biotech drugs.
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 November 2002 MargaretAnn Cross	Formulary Submission Process Catches On ... Slowly If drug purchasers are so bullish on what the Academy of Managed Care Pharmacy's Format for Formulary Submissions can do for them, why don't more of them use it?
Pharmaceutical Executive May 1, 2005 Erik Felker	Elephant or Specialist? The Bush Administration has put in place the groundwork for new market forces that will forever change how pharmaceuticals are commercialized. Although the long-term impact of this change is not known, unprepared companies are at a serious disadvantage.
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Pharmaceutical Executive January 1, 2011 Roger L. Williams	Ensuring Drug Quality: A Complex Task in a Globalized Era With increasing globalization and longer and more complicated manufacturing supply chains, the quality and safety of our medicines is at much higher risk today than it was a decade ago.
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 June 2007 Martin Sipkoff	Rebates for Anti-Anemia Drugs Draw Response From FDA, CMS Overusing erythropoiesis-stimulating agents to collect rebates can be really bad for the patient. Ripping off taxpayers and private payers is another concern.
Registered Rep. October 13, 2011 Mark Miller	Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season.
BusinessWeek January 21, 2010 John Carey	Making Personalized Medicine Pay Medco and other pharmacy benefit managers say future profits depend on matching drugs to patients based on their genes.
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.
Pharmaceutical Executive May 1, 2006 Huang, Pesile & Mozeson	Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster.
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...
Chemistry World March 25, 2010 Rebecca Trager	Big pharma scores in US healthcare reform President Obama has signed the biggest US healthcare reform since the 1960s, and although it is largely seen as a victory for the pharmaceutical industry, some analysts are characterising it as a 'double-edged sword'.
Chemistry World November 18, 2010 Ned Stafford	New drug pricing rules in Germany The law was approved on 11 November and will take effect from 1 January as part of an effort to rein in exploding costs for Germany's massive public health insurance system.
Pharmaceutical Executive July 1, 2006 Jill Wechsler	Washington Report: Hard Evidence The push for more useful information on medication effectiveness is shaping drug development and reimbursement.
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.