Radar on Drug Benefits

News Briefs

✦ CMS on March 11 rolled out a voluntary model that would set out-of-pocket costs for insulin at a maximum $35 copayment per 30-day supply throughout the benefit year for beneficiaries in participating enhanced Pa...
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© 2024 MMIT

Providers Protest Tenn. Blues’ New White Bagging Policy

An earlier version of this story incorrectly said that the program initially was to start Jan. 1 but that the insurer pushed it back to July 1. The program launched Jan. 1, with a six-month transition period ending ...
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© 2024 MMIT

New Generic HIV Drug Will Affect Payer Coverage of PrEP

A generic version of Truvada coming on the market later this year will affect how payers cover pre-exposure prophylaxis (PrEP), experts tell AIS Health. PrEP is a daily medication used by people at risk of HIV to pr...
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© 2024 MMIT

Analysts Say Opaque Pricing Helps Drive Drug Cost Hikes With Chart: Per-Person Prescription Drug Spending Increases Steadily From 2014 to 2018

A new study estimates that payers and patients spent a combined 26% more per person on prescription drugs in 2018 compared with 2014, with price growth far outstripping increased demand in driving drug spending. Ana...
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© 2024 MMIT

Express Scripts Report Touts 4.8% Drop in YoY Spending

In its annual drug spending report, PBM giant Express Scripts said it kept total pharmacy spending in line with the consumer price index while reducing year-over-year (YoY) spending by 4.8% for its most tightly mana...
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© 2024 MMIT

News Briefs

✦ The Institute for Clinical and Economic Review (ICER) and health care technology company Aetion are partnering to advance the use of real-world evidence (RWE) in assessing the cost-effectiveness of medicines, ST...
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© 2024 MMIT

CMS Backs Closed Medicaid Formularies…But Are They Legal?

As part of long-awaited guidance that CMS issued to states on Jan. 30 outlining how they can test-drive a fixed federal Medicaid budget and more program flexibilities, the Trump administration invited states to try ...
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Payers Test Ways to Control Rising Cost of Diabetes Drugs With Chart: Current Market Access to Select Insulin Drugs

With the cost of diabetes drugs still growing, PBMs and payers are looking for more innovative strategies to hold down costs. For some, that might include a strategy similar to the one recently unveiled by CVS Healt...
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PBM Integration Helps Drive Solid 2019 Earnings, Execs Say

The health care industry’s largest payers continue to make the case that they are gaining — or project to gain — substantial benefits from integrating PBM businesses. In particular, Cigna Corp. expects its ...
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Cancer, Neurology Drugs Lead 2020 Pharma Pipeline

In its quarterly drug pipeline trends report, OptumRx projected that 2020 will see large numbers of drug approvals for oncology drugs and identified 11 drugs with the potential to be blockbusters in the United State...
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© 2024 MMIT