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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 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 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 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 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.
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 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 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 August 2001 Patrick Mullen	The Expanding Role of Pharmacists Lobbying in Washington, monitoring state legislation and generally looking out for the interests of pharmacy programs run by health care plans and pharmacy benefit managers, Judith Cahill leads the Academy of Managed Care Pharmacy at an exciting, critical time...
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.
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 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 July 2000 John Carroll	Physicians Reconsider Taking On Pharmacy Risk They've been burned here in the past, but physicians - and the HMOs that they contract with - may have learned some lessons.
Managed Care September 2006 Martin Sipkoff	PBMs Raise the Curtain Efforts are under way to find out exactly how pharmacy benefit managers work their magic.
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 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 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 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 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 January 2001	Express Scripts' Formulary Rulings To Go Online The public will have a chance to see what until now has been, mostly, understood only by managed care insiders: how a prescription drug winds up on a formulary...
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 May 2006 Martin Sipkoff	Part D Means Health Plans Will Have To Pay Pharmacists Medication therapy management helps people to stay on their prescribed regimens. Part D plans can expect to start making payments for the service in 2007.
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?
Managed Care May 2004 Thomas G. Dolan	Pharmacist Care An Idea Whose Time Is Still Coming For more than a decade, it has seemed this idea would catch fire. But many insurers are still looking for evidence that it can reduce overall costs.
Managed Care December 2000 Michael D. Dalzell	Prescription Drug Reimportation: Panacea or Problem? Health plans concerned about the cost of pharmacy benefits might want to look at potential effects of prescription drug reimportation -- formulary issues and legal questions, to name two -- even if full implementation is a while off...
Managed Care October 2001 Patrick Mullen	Interview: Pharmacists in Need The executive vice president and CEO of the American Pharmaceutical Association says pharmacists are being inundated and need help...
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.
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.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
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?
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 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 October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Registered Rep. October 13, 2011 Mark Miller	Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season.
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.
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 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 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.
Chemistry World March 25, 2010 Rebecca Trager	Big pharma scores in US healthcare reform President Obama has signed the biggest US healthcare reform since the 1960s, and although it is largely seen as a victory for the pharmaceutical industry, some analysts are characterising it as a 'double-edged sword'.
Managed Care October 2007 Martin Sipkoff	Asheville's Legacy: Pharmacy Moves From Dispensing to Clinical Management It is an idea whose time has finally come: Today's clinical pharmacists are involved in virtually all aspects of medical care.
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.
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.
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.
Pharmaceutical Executive January 1, 2012 Christopher J. Piazza	Essential Questions for Essential Benefits A key consideration under the Affordable Care Act is how states select plans for drug coverage.
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 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.
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.
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 May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and 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