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Pharmaceutical Executive November 1, 2012 Lauri Mitchell	Who Pays for Specialty Medicines? Providers and patients fish for that delicate balance between access and abandonment.
Managed Care November 2007 MargaretAnn Cross	The Evolving Health Plan The consumer-directed health care model isn't taking the country by storm, but its innovations are influencing other coverage designs.
Managed Care November 2005 Patrick Mullen	This Biologics Industry Spokesman Knows That Health Plans Can Only be Won Over by the Financial Argument. Biotech's focus is expanding from products that treat relatively rare diseases to treatments for conditions that affect much larger populations, including various cancers, diabetes, rheumatoid arthritis, and asthma because of health plan costs.
Managed Care August 2007	Consumer-Directed Health Plans: Built to Last or Designed to Fail? A point-counterpoint debate about the effect of CDHPs on overall health and health care 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 September 2003 MargaretAnn Cross	Consumer-Directed Health Care: Too Good To Be True? People talk about it as the sure way to control costs and give consumers the choice they seem to want. Are we being realistic?
Managed Care May 2004 MargaretAnn Cross	Will Providers Seek New Contracts As Consumer-Directed Plans Grow? Although plans are not restructuring fee schedules in consumer-directed health plans, providers think their agreements need fine-tuning.
Pharmaceutical Executive November 1, 2013	Roundtable on Market Access Market Access is a window on what matters in the real world of soaring patient expectations and crimped payer budgets for innovation.
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
Pharmaceutical Executive August 1, 2012 Debbie Warner	Adapting to a New Era of Cancer Care Coverage and treatment decisions will be driven by value and defined differently by each stakeholder.
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 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.
Pharmaceutical Executive April 1, 2012	Special Section: Sunshine Act Still in the Shade Phase in of the Sunshine Act will force a reconsideration of the ethical consequences of all types of pharma meetings. How and to what extent remains to be seen.
Managed Care May 2005 MargaretAnn Cross	Are Consumers Really Directing Their Own Care? In theory, consumer-directed health plans put the reins of decision making into the hands of their members. But medical management departments are alive and well inside CDHPs -- and may even expand under these plan designs.
Managed Care April 2007	A Conversation With Emad Rizk, MD: Disease Management Beyond the Call Center The man who heads McKesson Health Solutions, the third largest disease management program in the country, says it's time to roll out a new model.
Managed Care August 2001	Four Views of Managed Care Ethics The evolution of managed care has posed ethical problems for physicians, plan administrators, and even patients. Four ethicists find that questions are many, while satisfactory answers are in short supply...
Pharmaceutical Executive March 1, 2014 William Looney	The Call to Community: A Conversation with Dr. David Nash Population health is the foundation for much of what is truly new in US health reform. For big Pharma, it represents yet another escalation in expectations.
Managed Care July 2007 Tom Reinke	Better Ways to Pay Providers Paying for coordinating care and for packages of services -- bundling and episodes of care -- may be the best bet for a modification of the unfettered fee-for-service system.
Managed Care February 2002 Mick L. Diede & Richard Liliedahl	Getting on the Right Track Converging forces are an economic train wreck waiting to happen. Avoiding a disaster requires an understanding of the interconnection of health care's stakeholders and the global consequences of their actions...
The Motley Fool August 10, 2004 Brian Gorman	Biotech Cost Control Will the high cost of therapies slow sales in the sector? Investors can avoid problems by paying close attention to companies' pipelines and reimbursement trends.
Pharmaceutical Executive February 1, 2013 William Looney	Pathways to Progress Cancer is increasingly understood as a collection of rare and mostly treatable conditions rather than the impregnable, monolith portrayed in popular culture. Industry experts review current and pending efforts to turn great science into good practice.
Managed Care January 2006 Maureen Glabman	What Doctors Don't Know About the New Plan Designs Physicians are fairly ignorant of what consumer-directed health care will mean to them in terms of relations with patients and health plans.
Pharmaceutical Executive September 1, 2013 Shantanu Agrawal	Making Sense of the Sunshine Act: A New Era for Drug Promotion Now that the Sunshine Act's Open Payments spending disclosure program is live, the federal government's lead officer for compliance explains how the new web-based system will work and how US industry, providers, and patients will be better off by making their relationships fully transparent.
Managed Care June 2005 Martin Sipkoff	The Re-Emergence of the Primary Care Physician A new model of care developed by the American Academy of Family Physicians places primary care physicians back at the center of care delivery.
Managed Care March 2006 MargaretAnn Cross	Deciding Factor: How Much Health Care is Discretionary? Defining discretionary health care is no easy task, but it may be imperative for 'consumer' health plans seeking to get patients more involved.
Pharmaceutical Executive September 1, 2012 Al Topin	Doctors' Words No Longer Gospel In the digital age, physicians don't call the shots when it comes to healthcare guidance. Marketers must appeal to multiple sources in seeking ways to garner patient adherence and loyalty.
Managed Care January 2005 Alice G. Gosfield	P4P: Transitional at Best Pay-for-performance (P4P) programs promise a fair shake for provider and insurance plan, but a former chairman of the National Committee for Quality Assurance sees many design flaws to overcome.
Pharmaceutical Executive September 1, 2008 Jeffrey S. Aronin	The Orphan Opportunity The Orphan Drug Act was passed 25 years ago. But the challenge of actually getting rare disease drugs and therapies to patients still remains
Managed Care October 2005 Bob Carlson	What Docs Hate Most About Plans Some insurers seem to have a knack for irritating their network physicians. The list is long, but five categories of irritants seem to recur most often.
Managed Care September 2004 Tony Berberabe	Can Physician and Health Plan Get Together Over Guidelines? Physicians are not the only problem. Health plans too often view guidelines as rigid routines rather than flexible aids to good practice.
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.
Managed Care June 2003 Thomas Morrow	The 'Heartbreak of Psoriasis' Has Met Its Match! New therapies that manipulate the immune system offer hope to patients and pose challenges to managed care.
Pharmaceutical Executive March 1, 2011 Jerry Coamey	Engage the Physician! New research shows that gauging the mind of the clinician is crucial to timely uptake of the new diagnostic tools offered by the genomic revolution
Pharmaceutical Executive October 1, 2010	When the Payer IS the Player As Medicare, Medicaid, and the nation's web of private payers gain market power, how can pharma stay ahead of the cost-containment curve?
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.
Pharmaceutical Executive November 1, 2014 Jill Wechsler	Outrage Grows Over Drug Pricing Insurers, physicians attack high-cost therapies in anticipation of specialty drug surge.
Managed Care October 2005 Martin Sipkoff	The Lure of Tax Reform Politicians on both sides of the aisle are considering tax reforms as a way of fixing the health care system. What might it mean for health plans?
Managed Care March 2004 Martin Sipkoff	Can Transparency Save Health Care? If everyone can see what everyone is doing, we'll have better care at lower costs. First task: Create common standards.
Pharmaceutical Executive January 1, 2014 Jill Wechsler	Pharma Challenges for 2014 Pricing and personalized medicine are key themes shaping drug development and marketing
Managed Care December 2007 John Carroll	How Doctors Are Paid Now, And Why It Has to Change Everyone knows about the perverse incentive of fee-for-service medicine, but that hasn't had much effect on its use.
Managed Care December 2005 Ricardo Guggenheim	Putting EBM To Work (Easier Said Than Done) Through widespread implementation of evidence-based medicine, the United States has its best chance of erasing the variations in care that currently extract such huge costs -- both human and financial -- from the health care system.
Managed Care June 2006 Amanda Brower	Retail Medical Clinics Draw Patients & Payers A growing number of health plans are adding retail health clinics to their networks and are realizing savings. But physicians voice concern over the quality of care provided to patients.
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.
Reason November 2004 Ronald Bailey	Mandatory Health Insurance Now! It will save private medicine in the U.S. -- and spur medical innovation.
Managed Care June 2005 MargaretAnn Cross	Consumer-Directed and Home-Brewed Regional health plans and small HMOs coming late to the consumer-directed health plan market haven't missed out -- yet.
Pharmaceutical Executive April 1, 2012 Feam & Lagus	Providing Access Now While regulatory frameworks and medical practices differ between countries, many patients still need early access to new drugs. Industry can help.
Managed Care December 2005 MargaretAnn Cross	The Ethical Way In a Season of Change Advancing technologies and new coverage designs are creating opportunities -- and obligations -- for health plan medical directors.
Pharmaceutical Executive March 1, 2013 Al Topin	Less Selling, More Time What can happen when pharmaceutical reps focus on the physician-patient conversation?
Managed Care May 2003 Wayne Miller	Higher Drug Copays Now Might Cause Problems Later The long-term impact of noncompliance must be considered before copayments are increased. This is especially true where chronic conditions are concerned.
Managed Care August 2002 Joyce Ochs	Managed Care's Use of Web Not Just for Marketing Anymore Virtually all MCOs today have Web sites as a matter of course. The challenge is to have a site useful enough to make people come back, while the operating challenge is to transfer selected company functions entirely or partially to the Internet to increase efficiency and reduce expenses.