December 23, 2013

The Centers for Medicare and Medicaid Services is encouraging health plans to cover patients' existing non-formulary drugs as though they were formulary drugs for the first 30 days after the Jan. 1 rollout of the insurance coverage provided under the Patient Protection and Affordable Care Act.

December 13, 2013

According to published reports, Express Scripts may be looking to start a "price war" among the makers of the latest generation of drugs for hepatitis C — which promise much shorter treatment times than standard therapies, but also cost significantly more — in an effort to bring down prices.

The stakes are certainly high. According to Centers for Disease Control and Prevention, there are 3.2 million people in the United States chronically infected with hepatitis C and hence at risk for liver cancer, and the CDC recommends that anyone born between 1945 and 1965 get tested for the virus.

December 13, 2013

Pharmacy benefit manager Express Scripts hopes to drive down the cost of new drugs to treat hepatitis C by pitting their manufacturers against each other, according to published reports.

June 11, 2013

The Annals of Internal Medicine published a study comparing generic utilization of common diabetes medications across two government programs — Medicare Part D and the U.S. Department of Veterans Affairs.

February 28, 2013

Pharmacy benefit managers are becoming increasingly adept at leveraging the power of generics to save client healthcare dollars and improve their own standing, reports indicated.

November 12, 2012

The PBM division of CVS Caremark is hoping to get patients to use lower-cost drugs for certain conditions by removing higher-cost drugs from its formulary, according to published reports.

August 14, 2012

You’ve seen the sign, probably early fall, posted right there on the marquee of the local pharmacy: “Most insurance accepted.” It means that when a patient stops by the pharmacy for a flu shot, the pharmacy can probably bill the health plan for the covered medical benefit.

May 17, 2012

More than 80% of health plans would require a drug manufacturer to demonstrate a clear clinical benefit compared with current branded and generic treatments in order for its drug to be placed in the plan's formulary, according to a new survey.

May 16, 2012

CVS Caremark has aggressively set its sights on enhancing medication adherence, and the initiatives are paying off as the company estimates that its PBM clients saved nearly $2.4 billion in 2011 because of improved medication adherence for chronic conditions, according to findings of its annual Insights Report.

May 11, 2012

E-prescribing owes a debt of gratitude to meaningful use. Without the Office of the National Coordinator’s inclusion of the capability as a core measure, enabling physician technologies may not have taken off with such vigor.

April 13, 2012

Walmart and healthcare partner Humana are out with a new prescription drug program called Rx4Value that guarantees savings and relies on the proven strategy of improving affordability by restricting choice to generic drugs.

July 12, 2011

South Dakota’s largest physician-owned health plan has adopted prior authorization automation technology from RxEOB for use across its membership, RxEOB said.

May 19, 2011

A drug for cardiovascular disease made by Boehringer Ingelheim has received preferred formulary status with AARP’s Medicare Part D plans, the drug maker said Thursday.

March 15, 2011

A drug used to prevent stroke in patients with a form of atrial fibrillation has won preferred Tier 2 formulary status with pharmacy benefit managers Medco Health Solutions and CVS Caremark.

October 19, 2010

A drug store chain and a leading provider of mobile drug reference tools and interactive...

August 16, 2010

Federal agencies enforcing new health-reform mandates must act to preserve patients’ access to the pharmacy...