Pharmacy Benefit Management
Prescription Solutions, A UnitedHealth Group CompanyInnovative online software puts clients in the driver’s seat and simplifies pharmacy benefit process: Take control of the many choices available
Online Tool Discloses All Drug Pricing Options As health care costs continue to escalate, consumers and legislators are demanding increased transparency in benefit and pricing information to help rein in these costs.
NCPA: AARP Report Finds Brand Name Drug Prices Soar as Large Pharmacy Benefit Managers Reap WindfallBrand-name prescription drug prices are increasing faster than the rate of inflation, and Pharmacy Benefit Managers may be the culprit
Pharmacy Strives for Drug Safety While Reducing CostsDavid B. Snow Jr. has built Medco Health Solutions into an enterprise recognized as one of the world’s most innovative health care companies and a leader in clinically driven pharmacy care.
Innovator Helps People Live Healthier LivesFocused. Bright. Driven. Innovative. Caring. Those are words often used to describe Jacqueline B. Kosecoff, CEO of Prescription Solutions, one of the nation’s largest pharmacy benefit management (PBM) organizations and a UnitedHealth Group company.
HealthWarehouse.com Reports 106% Revenue Growth in the Second Quarter 2010 Compared to 2009Leading retail mail-order pharmacy continues nationwide expansion with increased revenue growth
PharmMD and Prescription Solutions Go LivePharmMD program aimed at providing services to more than 6 million Medicare Part D members
NCPA Proposes Criteria for Grandfathered Health Plans, Pharmacy BenefitsThe National Community Pharmacists Association (NCPA) submitted comments to the Internal Revenue Service (IRS), Employee Benefit Security Administration (EBSA), and the Department of Health and Human Services Office of Consumer Information and Insurance Oversight (OCIIO) supporting patient choice and greater utilization of generic prescription drugs, as those three agencies develop criteria for maintaining Grandfathered Health Plan (GHP) status under the Patient Protection and Affordable Care Act (PPACA).
NCPA Statement on CVS Caremark-Aetna AgreementHealth Care Reform: Elimination of Retiree Drug Subsidy DeductionBy Bill Boies, Amy M. Gordon, Susan M. Nash, and Maggie McTigue, McDermott Will & Emery, LLP
NCPA Urges U.S. Office of Personnel Management to Adopt Transparent PoliciesNCPA Urges U.S. Office of Personnel Management to Adopt Transparent Policies for Pharmacy Benefit Managers in Federal Employee Health Plan, Health Insurance Exchanges
Health Care Reform: Elimination of Retiree Drug Subsidy DeductionBy Bill Boies, Amy M. Gordon, Susan M. Nash, and Maggie McTigue, McDermott Will & Emery, LLP
HealthPrize Strengthens Leading Adherence TeamWith the appointment of globally recognized health care and marketing executives to their advisory board, this innovative medication adherence company recruits top entrepreneurs and marketing professionals to sit on Advisory Board
‘Free’ Saves Members Money: Consumers Alter Behavior on PrescriptionsBy Dr. Thomas A. Kellenberger Vice President and Co-Founder, BidRx LLC
Forgotten Medications: The Secret Health Care Costs to EmployersBy Pamela Swingley, CEO and founder, RememberItNow!
Prescription Drug Data Key to Lowering Health CostsThere's a cure for high health costs--and you might say that it comes in pill form
NCPA Statement on CVS Caremark-Walgreens AgreementWalgreens, CVS pharmacy arrangement to remain intact
CVS Caremark Announces Plan To Remove Walgreens From PBM Pharmacy NetworkCVS Caremark Corporation announced June 9 that it will terminate Walgreens' participation in its retail pharmacy networks effective 30 days from today, or as otherwise may be required by applicable law or contract requirements
Study Shows Integrated Medical and Pharmacy Benefits Lower Costs, Promote Better Health At a time when employers are seeking innovative ways to control medical benefits expenses, a study from Highmark Inc. has revealed that the integration of medical and pharmacy benefits lowers overall medical costs while promoting better health.
New Ingenix TrendView Helps Employers Manage Medical CostsEmployers face intense pressure to control their medical costs while offering competitive health benefits that will attract and retain the best talent
Walgreens Will Not Participate in Future CVS Caremark Pharmacy Network Plans Walgreens will not participate as a provider in any new and renewed prescription drug plans awarded after June 7 to CVS Caremark’s pharmacy benefit manager
Reform Changes Lead Employers to Rethink Retiree Prescription BenefitsBig changes may be ahead with the impending changes to the Retiree Drug Subsidy
National Health Options Creates First Private National Healthcare Assistance Program for Employers, New “retail” coverage option includes free pharmacy discount car.
NCPA Commends FTC Delay of 'Red Flags Rule,' Urges Congress to Approve Pharmacy ExemptionToday, the U.S. Federal Trade Commission (FTC) announced that it would delay enforcement of the so-called "Red Flags Rule" from June 1, 2010 until December 31, 2010, in response to Congressional efforts to narrow the scope of the regulation.
Walgreens Restructures Health Care DivisionsWalgreens restructures health care divisions to provide integrated pharmacy, health and wellness solutions
Economic, Clinical Strategies Help Manage PharmacyAlthough prescription drug cost increases remain in the single digits as a new decade unfolds, the industry will continues to use economic and utilization management strategies to achieve the greatest possible return on its investment in prescription drugs.
Companies Face Worker, Health Care Challenges as Millennium Closes Overall Outlook for 2010
Behavioral Science Can Increase Therapy Adherence Cutting Costs and Improving Health
AmWINS Group Benefits Launches New Product To Protect Against High-Cost Specialty DrugsNew Specialty Pharmacy Protection™ Safeguards Brokers’ Self-Insured Clients By Carving Out Specialty Pharmaceuticals
Express Scripts to Spin-off Rx Outreach to Create Nonprofit Offering Prescription MedicinesNew organization to address growing needs of low-income Americans
NovoLogix brings cost savings structure to emerging world of medical pharmacyInsurers/Employers can save millions a year lost to imprecise and inconsistent coding
Coalition Urges Congressional Leaders to Strengthen PBM Transparency Provision in Final Health BillPowerful, Diverse Coalition Urges Congressional Leaders to Strengthen PBM Transparency Provision in Final Health Care Reform Bill
informedRx Receives Full URAC Pharmacy Benefit Management AccreditationAccreditation recognizes SXC's commitment to engaging and empowering consumers with the resources, tools and information they need...
CIGNA'S CoachRx … A Prescription for Better HealthCIGNA Takes a Bite Out of the High Cost of Medication Non-Compliance
U.S. Health Bill Passes Crucial Senate TestIn a middle-of-the-night vote, Democrats unanimously backed the first in a series of three procedural motions to cut off debate and move the bill to a final vote by at least Christmas Eve.
Four Ways to Reduce Prescription Costs Four critical programs can produce cost savings for prescription drug plan sponsors and participants
Express Scripts Completes Acquisition of WellPoint's NextRx SubsidiariesLong-term strategic alliance presents transformative opportunity to advance healthcare in America
Pittsburgh Business Group on Health Drug Program Lands Solid 1-2 Punch Drug Costs Dropped in 2008; New Contract Terms Meet Employer Goals, Estimated to Save $55 Million
NCPA Asks Medicare to Avoid Mail Order BiasEnsure Seniors Can Choose Their Pharmacy Based on the Facts
Prescription Solutions Receives Re-Certification from TIPPSSM For Pharmacy Benefits Transparency2010 Standards provide employers with the most rigorous level of drug purchasing transparency available in the marketplace
CVS Caremark and Microsoft HealthVault Expand Partnership to CVS/pharmacy CustomersCVS/pharmacy customers can now securely download their prescription history from cvs.com to their Microsoft HealthVault record
Walgreens Launches National Initiative for 90-Day Prescriptions at Community PharmaciesFlexible Program Promotes Choice and Better Patient Care while Delivering Greater Adherence to Medications and Significant Cost Reductions
Prescription Solutions Ranks Highest in Customer Service and Cost Competitiveness Factors...Prescription Solutions Ranks Highest Among Mail Order Pharmacies in J.D. Power and Associates Study One of Two Mail Order Pharmacies Ranked ‘Among the Best’
Economic Conditions Signal Long-Term Shift in Rx Benefit Approach90% of benefit providers identify increased incidence of chronic conditions as a key driver of costs
PCMA: Baucus Health Reform Plan Sustains Proven PBM Delivery Model Yielding Expanded Access, Lower CPCMA: Baucus Health Reform Plan Sustains Proven PBM Delivery Model Yielding Expanded Access, Lower Costs
Walgreen Plans Mac-like AttackMr. Wasson, 50, aims to replicate the Oak Brook-based burger giant's successful strategy of slowing down to rev up profit growth. Like McDonald's, he's throttling back new store openings and working to squeeze more sales out of existing outlets.
Wal-Mart Adds More Employers to Its Retail Pharmacy Fulfillment ProgramWal-Mart Stores, Inc. says it has added more employers to the pharmacy fulfillment program it launched with Caterpillar Inc. last fall. The retail giant also is piloting a mail-order pharmacy service in Michigan, but says it won’t integrate the two until it sees results from the mail-order program. Wal-Mart maintains that it’s not planning to jump into the pharmacy benefit management (PBM) business, however.
Prescription Solutions Modernizes Consumer Website with New Content and ToolsSite provides educational components powered by OptumHealth and new features to help customers make informed health care choices
Value-Based Insurance Design: Helping Employers Improve the Value of Health CareThe National Pharmaceutical Council (NPC) has released a new report on an important approach being used by leading edge employers for improving patient health outcomes - Value-Based Insurance Design (VBID).
Walgreens Joins Forces with Caterpillar to Lower Prescription Drug CostsDirect-to-Employer Program Builds on Walgreens and Caterpillar’s Efforts to Take Out Unnecessary and Hidden Health Care Costs
PBMs Say Plan Sponsors Can Achieve 70%+ Generic Rates Without Aggressive TacticsPharmacy benefit managers (PBMs) that have achieved generic drug fill rates of 70% or more say aggressive management tactics are not as important as a focus on educational and communication tools and an overall formulary design aimed at obtaining the lowest unit price rather than the highest rebate revenue.
Aetna Shops Its PBM Arm Amid Sector's ConsolidationInsurance giant Aetna Inc. has put its pharmacy-benefit management business on the block, say several people familiar with the matter, as the industry embarks on a widescale consolidation.
Leading Health Website Offers New Approach to Comparative MedicineRateADrug.com introduces a methodical way for patients to compare conventional treatments to alternative and complementary therapies.
Medco Profit Rises, Beats Street viewMedco Health Solutions reported a higher-than-expected quarterly profit
Emdeon Acquires eRx Network, LLCAcquisition of pharmacy services innovator provides enhanced leadership in ePrescribing and pharmacy claims management
National Survey Finds Americans Want Choice in Health InsuranceMany opposed to government run health care system
Two Prescription Solutions Executives Named to Prestigious Health Care BoardsJohn Jones Elected to Academy of Managed Care Pharmacy and Dr. Brian Solow Appointed to the Pharmacy & Therapeutic Society
Despite Escalating Costs, Employee Healthcare Benefits Aren’t on the Chopping BlockEmployers Continue to Regard Healthcare Benefits Programs as Vital to Maintaining a Healthy, Productive and Loyal Workforce during a Down Economy
Home Prescription Delivery Benefits Employees, BusinessesLowe’s and Express Scripts Pilot An Innovative Pharmacy Benefit Model
New Research from EBRI: Many Support Lower Cost Sharing to Change Health Care System Use Many Americans support the use of lower cost sharing as an incentive to change the way individuals use the health care system
FieldMedia Announces Convergence of Successful Web Communities With Launch of EmployersWeb.comPrescription Solutions Provides Real-Time, Multi-Provider and Multi-Pharmacy Intervention Program...Prescription Solutions Provides Innovative Real-Time, Multi-Provider and Multi-Pharmacy Intervention Program to Prevent Dangerous Drug Interactions more details
Solutions Outlook: 2009 Pharmacy Benefit Innovation Focuses on Improving Health Status, OutcomesEmerging pharmacy trends offer opportunities for employers to increase ROI
Integrated Worksite Pharmacy Saves Time and MoneyMaricopa County is the first employer in Arizona too offer both an integrated onsite pharmacy and a health center. The clinic-pharmacy arrangement between Maricopa County and Walgreens drugstore chain and Take Care Health Systems, a wholly owned subsidiary of Walgreens, is believed to be the 1st of its kind for any government in the nation.
Health Evolution Partners Announces Innovation 2009 Annual ConferenceSummit to Explore Impact of Economic Environment and Health Reform On Health Care Innovators and Investors
IBT Selects Prescription Solutions as its Preferred PharmacySixth consecutive endorsement highlights Taft-Hartley trusts’ interest in offering high quality, low-cost pharmacy benefits to its union members
PBMs Increase Role in Helping Employers and Consumers Achieve Quality Care at a Cost SavingsWhat Employers Want From Health Insurers--NowIn 2008, PriceWaterhouseCoopers' research team surveyed senior executives at more than 100 large US-based multinational companies and more than 250 privately held small companies. The large companies each have an average of 8,000 employees and revenue of about $3 billion. The small employers each have a workforce of about 200 and less than $50 million in revenue. In addition, PwC surveyed more than 500 human resources executives separately on benefit plan design issues. This white paper discusses the results of this survey.
What Is Walgreens Thinking?FormularyA formulary is a list of prescription drugs covered by a particular drug benefit plan.
WellPoint Introduces International Medical Tourism Pilot Program Global Health Care Partnership with Serigraph, Inc. Reduces Costs for Members Undergoing Elective Procedures in India
First HSA Offers DestinationRx Drug Comparison and Pricing ToolFirst HSA Offers DestinationRx Drug Comparison and Pricing Tool
Medicare Prescription Drug, Improvement, and Modernization ActMedicare Prescription Drug, Improvement, and Modernization Act provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program.
Prescription Solutions To Provide E-Prescribing Services Through SureScripts-RxHubE-Prescribing Will Allow for Reduced Prescription Errors and Increased Safety for Consumers
Prescription Solutions Receives TIPPSSM Certification For Pharmacy Benefits Transparency StandardsMeeting PBM transparency standards opens new markets for Prescription Solutions
Prescription Solutions Receives J.D. Power and Associates Highest Mail Order Pharmacy RankinCompany Received the Highest Score Among Mail Order Pharmacies in 2008 National Pharmacy Study
Prescription Solutions Launches New Brand and Online PresenceBrand attributes focus on delivering more benefits at maximum value
Prescription Solutions Achieves Two URAC Accreditations Prescription Solutions achieves two new national URAC accreditations becomes one of the first PBMs to receive dual accreditations in mail service and specialty pharmacy.
drugstore.com Aligns With New FSA Transaction Standardsdrugstore.com Aligns With New FSA Transaction Standards to Identify Eligible Over-the-Counter, Vision and Pharmacy Products
drugstore.com inc. Reports Solid Revenue Growth & Record Gross Margins in the Third Quarter of 2008drugstore.com inc. Reports Solid Revenue Growth and Record Gross Margins in the Third Quarter of 2008
drugstore.com and Rite Aid Announce Restructured Strategic Partnershipdrugstore.com and Rite Aid Announce Restructured Strategic Partnership
Pharmacy Benefit ManagementA Pharmacy Benefit Manager (PBM) is a third party administrator of prescription drug programs that organize the market for prescription drugs. PBMs secure deep discounts from drug manufacturers and retail pharmacies for large employers or health plans.
Wired Doctors: Entering the Age of e-prescribing 2008 CDHC Superstar Awards: Pioneers in CDHC We've awarded top innovators in health care these coveted honors for excellence and innovation in the rapidly changing world of CDHC. Read about these outstanding companies and the people at their helm as they lead the way with innovative plan design, implementation, and leadership. Inside are the profiles of the winners and finalists in each of the 8 categories.
Engaging Consumers to Reduce Pharmacy Benefit Costs PBMs that engage employees reduce long-term expenses for the employee, the employer, the PBM, and the plan sponsor. Here’s how they are doing it and how it can work for your organization.
Mail Order Pharmacy is a Boon for CDHC Pharmacy costs are arguably one of the most important components of
consumer-directed health care. A significant and growing part of health
care expenses, they are ripe for innovation and consumer involvement.
It may be some time before consumers truly get to direct their health
care, but they can take some steps to save money and increase safety
with some medications, and employers are in the position to make
significant changes to their pharmacy benefit management to help their
business while looking out for their employees.
Here are perspectives from some leaders in the field.
Mail Order Pharmacy Offers Added Benefits Mail service pharmacy offers not only cost savings and convenience, but also programs that help members use medication appropriately, consistently, and safely.
Will Your CDHC Pharmacy Plan Cost Share or Merely Cost Shift? Share your financial health care load and benefits with your employees by designing a pharmacy benefit plan that optimizes the dollars spent by both parties.
Slash Costs With an Effective CDHC Plan Design"Does CDHC work? Absolutely, and it works as much for employees as for the employer, but the path is long and one needs to think outside the box when looking for ways to implement it—through careful plan design—and communicate these programs on a regular, consistent basis throughout the year." The City of Arlington, Texas achieves positive results with new CDHC plan design.
WellPoint NextRX: Leading Healthy Change by Delivering the Total Benefit SolutionPBM Stakeholders Will Work to Leverage Investment in Prescription Drugs in 2008Get in the Mix With a Proactive ApproachHow to use generics and drug mix for greater savings.
Let’s Be Clear: Transparency is Key to Drug CostsWhat administrators want—besides lower costs—is transparency. But what they are finding in today’s market is that transparency may be in the eyes of the beholder.
How To Insure the Success of Your Consumer-Directed Health Care ProgramSince more than half of all consumer health transactions involve pharmacy, the success or failure of consumer-directed health plans rides on the information and support available to members. Here are five fundamentals of a successful consumer-directed pharmacy plan that employers of any size can use to increase consumer-directed health plan success and adoption rates.
Pharmacist Coaches Reduce Chronic Disease CostFewer than 50 percent of people with chronic health conditions receive care according to evidenced-based guidelines, yet these conditions account for 75 percent of the country's medical care costs.