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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 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.
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 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?
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 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 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 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?
Pharmaceutical Executive January 1, 2012 Mason Tenaglia	Letting the Facts Get in the Way An empirical defense of coupons and copay offset programs.
Pharmaceutical Executive December 1, 2011 William Looney	The Medicines Adherence Challenge Keeping skittish patients on their medicines ought to be a strategic priority for Big Pharma, but is it? An expert round table examines how best to make progress and agree on some practical steps for incorporation in the campaign agenda.
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 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.
Managed Care December 2003 MargaretAnn Cross	Will New Benefit Design Harm Some Patients? In the past, reducing demand for care by raising patients' costs has resulted in the loss of some needed care. Can we avoid the trap?
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 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 March 2000	Three-tier drug copayments in; closed formularies on way out?
Managed Care August 2004 MargaretAnn Cross	Employers Take the Lead In Drug Benefit Design Companies test new approaches to funding the pharmacy benefit with the goal of saving money overall.
Managed Care February 2007	Study: Copayments do Affect Compliance Managed care decision makers have a powerful tool that affects patient compliance with antihypertensive medications - the copayment level.
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
Pharmaceutical Executive February 1, 2014 Anbil et al.	Managed Markets: Positioning Your Product For Success with Pull Through Strategies A patient-centric approach to drug development delivers the benefits that actually create value
Managed Care October 2004 Arthur Lazarus	Formulary Restrictions Sometimes Harm Patients Much more research is needed to determine the full effect of drug benefit designs. Quality must be the foremost concern.
Managed Care January 2004	Increasing drug copayments deter compliance Raising copayments in tiered prescription drug plans increases the likelihood that patients will stop taking prescribed medications, according to a recent study published in the New England Journal of Medicine.
Managed Care August 2004 Alan Lotvin	Specialty Pharmacy Presents Unique Set of Challenges Only a small percent of a typical health plan's population takes medicine for conditions outside the generalist's scope. But it's a big portion of the drug bill.
Pharmaceutical Executive March 3, 2014 Mason Tenaglia	The New Metrics of Market Success Profitability now depends on metrics to help companies answer a key strategic question: "stay the course" with more investment in sales and marketing? Or "stand down" and deploy those scarce assets somewhere else?
Managed Care March 2006	The Formulary Files Four or more tiers that are common among PDPs and MA-PD plans.
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 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 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 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.
Pharmaceutical Executive September 1, 2011	Should the US Gamble with Risk Sharing? Especially when payers come to the table holding the best cards, leaving industry second-guessing its strategy.
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 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...
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 January 2008	Utilization Slowed by Switch From Copayment to Coinsurance Switching from a copayment benefit design to a coinsurance benefit design slowed the growth of total per-member per-month (PMPM) expenditures for all drug classes but did not have a significant effect on overall PMPM utilization.
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.
Pharmaceutical Executive March 1, 2012 Paolo De Marino	Registering Value: Always in the Eye of the Beholder The organizational disconnect between marketing and market access is curable if both groups focus on what counts: who's making the final purchase.
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 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 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 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.
Pharmaceutical Executive February 1, 2012 Sarah Krug	Introducing the 'Chief Patient Officer' Now is the time for pharma companies to appoint a Chief Patient Officer, a new position designed to build an accord around patient trust.
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.
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 March 2008	Drug Caps Lower Spending, but .... These policies tend to make consumers shoulder some of the cost of prescriptions and the cost could be a barrier to medication adherence.
Pharmaceutical Executive April 1, 2011	Off-Label But On Point? Use of off-label drugs is a balancing act for physicians, and poses even more problems for pharma. The FDA is moving slowly to help.
Managed Care October 2005 Martin Sipkoff	Restrictive Formularies May Be Contagious It's the law of unintended consequences: A restrictive drug formulary maintained by a health plan may influence how physicians treat patients unaffiliated with that plan. What does this mean to managed care?
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 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...
Managed Care November 2002 Frank Diamond	Companies Leaning on Workers in Battle Against Pharmacy Costs A new urgency means that tiered formularies and higher copayments will become even more widespread, a recent survey indicates.
Pharmaceutical Executive August 1, 2011 Jennifer Ringler	The Adherence Fight: A TKO? Why does the match against medicines compliance always seem to end in an easy knockout?