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Pharmacy Benefit Management
PBMs, Health Plans Are Taking Proactive Steps to Address Critical Drug Shortages From Drug Benefit News - While payers are helpless to stop the increasing problem of drug shortages, health plans and PBMs can take proactive measures to address this problem for their clients, from working with the member to going all the way up the supply chain to the manufacturer, two pharmacy experts tell DBN. “There has been a lot of press on this issue in the past few years and we are getting more questions from clients on the issue of drug shortages,” reports Allen Dunehew, vice president of strategic sourcing at Express Scripts, Inc. Read more
2012 Outlook: Despite Buzz, Narrow Networks Haven’t Seen Widespread Adoption, Say Experts From Drug Benefit News - According to predictions made by several PBMs and pharmacy benefit consultants in DBN’s last Outlook poll, 2011 was slated to be the year of the narrow network (DBN 1/7/11, p. 1). From incentive-driven networks to limited pharmacy panels, plan sponsors were supposedly chomping at the bit to achieve savings through these restrictive network designs. Read more
2012 Outlook: With Biosimilars Guidance Expected Soon, Payers Need to Plan Benefit StrategiesFrom Specialty Pharmacy News - Multiple sources tell SPN that the release of biosimilars guidance is imminent, but as of SPN’s Jan. 3 deadline, the expected guidance had not yet been issued. The FDA, though, last month released proposed recommendations for a biosimilars user fee program that echoed those under the Prescription Drug User Fee Act (PDUFA). Gillian Woollett, Ph.D., vice president at Avalere Health LLC, says the FDA “has promised to soon publish three draft… Read more
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Pharmacy Benefit Management Blog
By Angela Maas - February 9, 2012
The FDA today issued three draft guidance documents on biosimilar development. Scientific Considerations in Demonstrating Biosimilarity to a Reference Product describes how the FDA will determine biosimilarity through a stepwise approach to evaluating evidence. Quality Considerations in...
By Lauren Flynn Kelly - February 2, 2012
The comment period for responses to HHS’s Dec. 16 bulletin on essential health benefits packages has just closed, and a variety of stakeholders have expressed concerns over the agency’s intent to give states “flexibility” in choosing an existing health plan to define the benefits that must be...
By Angela Maas - January 27, 2012
With specialty drugs being adjudicated under both the pharmacy benefit and the medical benefit, health plans can run the risk of incentivizing members to choose a drug based on their out-of-pocket cost share. According to data from The Zitter Group, 35% of 40 payers that have a cost-sharing level...
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