Radar on Drug Benefits

About 1,750 Medicare Rx Plans Join Fixed-Insulin-Copay Demo

The Trump administration on May 26 shared new details about a program that offers diabetic seniors access to a variety of insulin products for a maximum $35-per-month copay. More than 88 health insurers offering ...
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Navitus Achieves Double-Digit Savings for New Clients in 2019

Navitus Health Solutions, a PBM that touts a 100% rebate pass-through model and a lowest-net-cost formulary, says it is seeing success in moderating total net cost per-member per-month (PMPM), particularly for new c...
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CVS Reports Lowest Drug Trend in Years

CVS Health Corp.’s 2019 drug trend report shows a 1.4% overall trend, the lowest in five years, and said 41% of its commercial clients saw negative trend. Specialty drugs accounted for almost half of all spending ...
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News Briefs

✦ A poll by the Kaiser Family Foundation found that the deepening economic crisis has made some patients struggle to afford their prescription medication, among other essentials. According to the poll, 8% of Ameri...
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PBMs Post Strong 1Q, but Questions Loom About Rest of 2020

Major PBMs reported strong results for the first quarter of 2020 as members rushed to fill prescriptions in March ahead of the COVID-19 pandemic. However, financial analysts warn the pandemic could have unpredictabl...
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Potential COVID-19 Treatments’ List Prices vs. Minimum Manufacturing Costs

On May 1, the FDA authorized Gilead Sciences, Inc.’s experimental antiviral drug remdesivir for emergency use in seriously ill COVID-19 patients. A 10-day course of remdesivir could cost around $4,500 if the drug ...
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With Costco Now in its Corner, PBM Navitus Thinks Big

Serving just 6.2 million members, Navitus Health Solutions — a PBM owned by St. Louis, Mo.-based integrated health system SSM Health — is hardly one of the industry’s major players. But given that it features ...
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Experts: COVID May Cause Permanent Rx Delivery Changes

Industry experts expect the COVID-19 pandemic and related economic crisis, in addition to the trend of vertical integration in the PBM sector, will increase those companies’ direct interaction with consumers. The ...
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Express Scripts Rolls Out Drug Discount Program for Newly Uninsured With Chart: Participating Brand-Name Drugs in Express Scripts’ Parachute Rx

Promising “extraordinary prescription savings for extraordinary times,” Express Scripts on May 7 unveiled a new program that offers medication discounts for Americans who lose their health coverage amid the econ...
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News Briefs

✦ In its final Notice of Benefit and Payment Parameters for the 2021 benefit year, CMS crystallized a controversial policy of allowing commercial health insurers to prevent drug manufacturer coupons from counting ...
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