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Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
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.
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 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 July 2001 Bob Carlson	Oregon Attempts To Blaze Trail With 'Reference-Based' Formulary Pharmaceutical makers invest enormous sums in R&D -- but they also reap enormous profits. States are impatient with the appearance that creates...
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.
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.
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 February 1, 2014 Anbil et al.	Managed Markets: Positioning Your Product For Success with Pull Through Strategies A patient-centric approach to drug development delivers the benefits that actually create value
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 June 2003	HMO, Medicaid formularies exhibit surprisingly small differences When you compare HMO and Medicaid formularies for coverage in major therapeutic areas, you find that the differences are relatively small, with Medicaid plans being somewhat less stringent.
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.
Managed Care October 2002	HMO drug formulary access increases for COX-2s Access to Celebrex and Vioxx under HMO drug formularies has increased about 50 percent over the past two years, according to data from MediMedia Information Technologies' Formulary Compass.
Pharmaceutical Executive March 3, 2014 Mason Tenaglia	The New Metrics of Market Success Profitability now depends on metrics to help companies answer a key strategic question: "stay the course" with more investment in sales and marketing? Or "stand down" and deploy those scarce assets somewhere else?
Managed Care December 2003	Electronic prescribing has no effect on formulary compliance A retrospective analysis of claims data from Aetna indicates that systems that allow physicians to enter prescriptions electronically on a handheld device that also provides drug information and formulary status have no significant effect on compliance with formularies and utilization of generics.
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 March 2007 Louis W. Hutchison	Unable to Carry Cost Burden, Payers Seek Other Remedies The pharmacy benefit landscape of today is all but unrecognizable from its predecessor of just a decade ago. Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Pharmaceutical Executive November 1, 2013	Roundtable on Market Access Market Access is a window on what matters in the real world of soaring patient expectations and crimped payer budgets for innovation.
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.
Pharmaceutical Executive September 1, 2005 Tenaglia & Angelastro	No Margin for Error Pharmaceutical companies that will be forced to cut back on sales and marketing spending must focus on value, not volume. Here's how to reduce your spending where it matters the least.
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.
Pharmaceutical Executive November 1, 2012 Lauri Mitchell	Who Pays for Specialty Medicines? Providers and patients fish for that delicate balance between access and abandonment.
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.
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...
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 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...
Managed Care December 2001 MargaretAnn Cross	Increased Pressures Change P&T Committee Makeup Formulary committees once were stocked with academics and administrators. Today, primary care physicians, specialists, and retail pharmacists play a bigger role, and tomorrow's membership will be even more diverse...
Managed Care February 2002 Joyce Ochs	E-Prescribing Gets More Enticing Physicians today are writing prescriptions for patients on palm-held devices that seem eerily akin to medical practice on the Starship Enterprise...
Pharmaceutical Executive July 1, 2012 Jill Wechsler	Who Will Pay for New Drugs? Comparative research documenting value and affordability is key to obtaining coverage for high-cost therapies.
The Motley Fool February 25, 2010 Brian Orelli	An Untouched Market Waiting to Be Captured Unfilled prescriptions are a potential boon to drug companies.
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.
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 November 2002 Frank Diamond	Companies Leaning on Workers in Battle Against Pharmacy Costs A new urgency means that tiered formularies and higher copayments will become even more widespread, a recent survey indicates.
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
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 March 2008	PDP Drug Restrictions Block Comparison Shopping A review of 169 commonly used drugs covered by Medicare Prescription Drug Plans (PDPs) reveals that only 4 of the 10 largest plans by enrollment have all of those 169 drugs on formulary.
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 Thomas Morrow	Specialty Pharmacy Meets Niche Company Expertise As new specialty pharmacy care becomes more dominant, companies devoted to managing these products and their associated costs are finding a market.
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?
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 March 2004	More State Medicaid Programs Use Preferred Drug Lists To Manage Costs Medicaid, enacted in 1965, is currently costing over $200 billion per year. With rapidly rising health care costs, including prescription drugs, state Medicaid budgets are feeling the strain. Here's what they're trying to do to manage.
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 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...
Managed Care December 2000	AMCP To Test New Guidelines For Formularies The Academy of Managed Care Pharmacy thinks there's a better way for health plans and pharmacy benefit managers to make formulary decisions than by simply looking at line-item budget figures...
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.
Pharmaceutical Executive August 1, 2005 Kevin Barnett	Part D Phase 2 Pharmaceuticals have been scrambling to get their Medicare contracting in order. Now it's time to figure out part D marketing and sales. Here's a checklist for the months ahead.
Managed Care August 2007	Incentive Formularies Have Minimal Effect A brief look at the effect of changes in drug benefit design on pharmaceutical use and spending.
Managed Care March 2005	ED drugs covered, but managed care unmoved Health care insurers account for the coverage of erectile dysfunction drugs.
Managed Care November 2004	Tiered Formularies Open the Potential for Lack of Access to Needed Drugs Tiered formularies that have additional incentives for preferred medications could create the potential for therapeutic compromises.
Pharmaceutical Executive May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.