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Pharmaceutical Executive January 1, 2012 Mason Tenaglia	Letting the Facts Get in the Way An empirical defense of coupons and copay offset programs.
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?
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
Managed Care March 2008 Martin Sipkoff	PBMs' Rebate Income Threatened By Lawsuits and Move to Generics A recent court settlement may affect the way the PBM industry makes profits, but could it also lead to higher drug costs?
Pharmaceutical Executive October 1, 2008 Chris Biddle	Stop the Bleeding Pharmaceutical manufacturers overpay pharmacy benefit managers millions of dollars each year in rebate overpayments. Here's how to stop the leakage.
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.
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.
Managed Care July 2004 Maureen Glabman	Wish List: 10 Things You Want From Your PBM One auditor estimates that 3 percent to 10 percent of pharmacy benefit manager (PBM) claims are processed incorrectly -- always in favor of the PBM.
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...
Pharmaceutical Executive November 1, 2012 Lauri Mitchell	Who Pays for Specialty Medicines? Providers and patients fish for that delicate balance between access and abandonment.
Pharmaceutical Executive August 1, 2008 Mason Tenaglia et al.	Inside the Doughnut Hole An answer to your question: What does the Part D coverage gap do to drug sales?
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.
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
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 October 2005 Martin Sipkoff	Restrictive Formularies May Be Contagious It's the law of unintended consequences: A restrictive drug formulary maintained by a health plan may influence how physicians treat patients unaffiliated with that plan. What does this mean to managed care?
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 March 2000 Tim Sawyers	Test Prospective PBM Before Signing Contract How to select, then monitor a pharmacy benefit management company, from a consultant and former HMO director of pharmacy services.
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 December 2003 Tony Berberabe	Why Do FEHBP and Big Unions Excel at Managing Drug Costs? Pharmacy benefit managers can do only so much to keep drug price increases in the single digits. Initiatives instituted by health plans can help in this effort.
Pharmaceutical Executive December 1, 2008 Jill Wechsler	Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers.
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 March 1, 2007 George Koroneos	Marketing to Professionals: The Formulary Rebound Marketers' professional strategies often fall on deaf ears when there is a cheap alternative available. Here are some tactics that make your brand heard.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
Pharmaceutical Executive May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.
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.
Pharmaceutical Executive February 1, 2009 Jill Wechsler	Securing Savings A close look at the healthcare industry will separate real cost-cutting measures from money-saving myths.
Pharmaceutical Executive October 1, 2006	Sales and Marketing: Where the Buck Stops Pharma's ultimate customer is the employer - the guy who pays the health plan's bill. Here's what he wants to know about drugs.
Managed Care January 2008 Thomas Kaye	Now Is the Time for Pharmacy Performance Incentives We've made strides in increasing the transparency of pricing in the pharmacy supply chain, and now we need to change dispensing behavior.
Managed Care June 2006 John Carroll	When New Drugs Are Costly, How High to Raise Copays? As some pretty costly, yet very useful, drugs are introduced, will new formulary designs deny access to needy patients?
Pharmaceutical Executive September 1, 2012 Stan Bernard	The Payer C Change: From Customers to Competitors "Payers have evolved to become powerful global contenders with pharma for increasingly limited funding of drug budgets." Understanding why and how this payer shift to dominance occurred is critical for pharmaceutical professionals in adjusting their business model.
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
Managed Care November 2005 John Carroll	FTC Report Arms PBMs In Battle With Drugstores Congress passed the Medicare Modernization Act allowing pharmacy benefits managers to participate in Medicare Part D.
Managed Care June 2003 Thomas Kaye	Mail Order Pharmacy -- Savings or Added Cost? Mail order programs can provide savings, but HMOs need to ensure that they are actually receiving sufficient value.
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.
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...
Pharmaceutical Executive June 1, 2011 Andrew Matthews et al.	Managing Product Lifecycle Patent expiries are inevitable, but brand teams should look to graduate the sales curve.
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.
Managed Care February 2007 Martin Sipkoff	As Drug Payment Model Changes, Confusion Grows Among Insurers Purchasers are hopeful that life after "average wholesale price" will be simpler, fairer, and, with luck, easier to grasp.
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 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...
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Pharmaceutical Executive November 1, 2005 Patrick Clinton	Are We Aligned Yet? A Medicare Part D Roundtable The most salient feature of the Medicare prescription drug benefit is its uncertainties.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
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 July 1, 2005 Jill Wechsler	Washington Report: The e-Bandwagon The federal government is driving e-Rx adoption by establishing standards that Medicare drug plans will have to adopt by 2009, and HHS officials are pushing to make this happen much earlier.
Pharmaceutical Executive August 1, 2012 Debbie Warner	Adapting to a New Era of Cancer Care Coverage and treatment decisions will be driven by value and defined differently by each stakeholder.
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 June 1, 2009	Pay For Play The P4P movement is here. Pharma marketers, it's time to take note.