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Managed Care October 2001 Bob Carlson	Trying To Get Control of Drug Costs, Florida Earns Kudos -- and a Lawsuit Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit against Florida's Agency for Health Care Administration, challenging a new Medicaid formulary that requires manufacturers to pay supplemental rebates to have their drugs included...
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 November 2002 John Carroll	Drug Companies Crying Foul Over Medicaid's Formulary Push With states' preferred drug lists spreading like a prairie wildfire, the manufacturers have mounted a furious legislative counterattack, funding grass roots campaigns aimed at fanning the opposition in state legislatures even as they wage a legal war in state and federal courts.
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 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 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 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?
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 November 2004 John Carroll	Medicare Formulary Model Seen by Many as Too Inclusive The issue is how extensive the list of covered medications should be for the new Medicare pharmaceutical benefit. The stakes are enormous.
Managed Care December 2000 Bob Carlson	3 New England States Prescribe Innovative Ways To Cut Drug Prices It's too soon to tell whether Maine's prescription drug price control law will survive a legal challenge by drug makers. But private efforts and another innovative strategy -- a plan by Maine, Vermont, and New Hampshire to purchase prescription drugs jointly -- are moving ahead...
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.
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, 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.
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 October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
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.
Reason April 2001 Ronald Bailey	Goddamn the Pusher Man Why does everybody seem to hate the pharmaceutical industry?
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...
BusinessWeek June 2, 2011 Kresge & Connolly	A New Pricing Game for Drugmakers in Europe Germany's new rules tying pharmaceutical prices to greater efficacy is worrying companies.
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...
Pharmaceutical Executive February 1, 2011 Jon Zifferblat	China: Business as UNusual If there is one market that requires a click on the 'refresh' button, it's China. General Biologic provides a snapshot of what's ahead for Big Pharma in the country
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'.
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 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...
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 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 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.
Pharmaceutical Executive October 1, 2005 Jill Van Den Bos	Formulary Additions: The Big Picture Product managers at pharma firms know how fiercely new drugs compete for inclusion on health plans' formularies. An actuarially sound, full-budget-impact model may be out of reach. But companies could express data in units that a health plan can integrate into its own internal actuarial analysis.
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...
Managed Care April 2005 John Carroll	Can Managed Care Programs Rein in Medicaid's Runaway Budgets? Cadillac or Yugo care for the poor? Fee-for-service or managed care? The states have a lot on their minds as the Medicaid monster grows and grows.
CFO Kris Frieswick	Clinical Trials A new kind of pricing pressure puts pharmaceutical CFOs in an unfamiliar role: evangelist...
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 March 2005	'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program.
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.
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 August 1, 2012	Sunny Outlook for Biopharm 2020? Albert Wertheimer looks beyond today's dark clouds with a comparatively sunny forecast for the biopharm industry in 2020. Just watch out for the harsh light of complacency.
Pharmaceutical Executive September 1, 2012 Stan Bernard	The Payer C Change: From Customers to Competitors "Payers have evolved to become powerful global contenders with pharma for increasingly limited funding of drug budgets." Understanding why and how this payer shift to dominance occurred is critical for pharmaceutical professionals in adjusting their business model.
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 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.
Pharmaceutical Executive December 1, 2008 Jill Wechsler	Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers.
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.
Pharmaceutical Executive January 1, 2011 Jill Wechsler	Politics & PDUFA Pharma companies will assess health reform, negotiate user fees and keep an eye on federal prosecutors in the year ahead.
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 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...
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 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 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.
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.
Pharmaceutical Executive April 1, 2011	Revisiting Reform Courts, Congress review policies and programs shaping drug costs and access.