Our leading subject matter experts share their insightful analysis and points of view to help you stay abreast of industry trends
Manufacturers engage with managed care organizations (MCOs) in a number of ways, from deep conversations regarding clinical indications and brand coverage to general sessions focused on product portfolios and overall…
Artificial Intelligence (AI) technology and ChatGPT are disrupting countless industries around the world. For healthcare, the possibilities appear promising, with organizations striving to improve patient outcomes and the overall quality…
From the spring of 2020 to March 2023, Medicaid gained approximately 20 million new members, thanks in large part to the provision for continuous enrollment during the pandemic. Once Medicaid…
For decades, payers have used prior authorizations (PA) with the intent of curbing costs by preventing the unnecessary use of medical procedures or treatments. But in recent years, more and…
When a pharma company secures expedited approval for a drug in development, everyone involved is usually thrilled. After all, a faster approval process means that patients in need will be…
Due to the end of the public health emergency for COVID-19 and subsequent redeterminations for Medicaid, health plan enrollment data has become increasingly volatile.
As of this spring, states were…
Recently, payers have started to use the phrase “member disruption” to refer to the potential impact of an impending formulary change on their members. This qualitative term is mentioned with…
For manufacturers, the success of a new brand hinges on its uptake in the first few months after launch. Many pharma companies are surprised to realize that payer coverage is…
Dallas Mavericks owner and venture capitalist Mark Cuban is taking aim at drug prices with his discount prescription drugs startup, Mark Cuban Cost Plus Drug Company. However, payers are divided…
In an effort to lower the cost of specialty drugs, many payers have initiated site-of-care optimization strategies. By encouraging patients to receive therapies in more cost-effective settings — such as…
