Drug Costs

Reshaping the PBM, Payer Relationship Could Improve Access to Care

March 4, 2024 - Pharmacy benefit managers (PBMs) and health insurers have significant influence on prescription drug costs and, as a result, on access to care, but the traditional model for this relationship may not support affordability.  PBMs were designed to alleviate payers of the responsibility of coordinating with pharmaceutical manufacturers. While the services that PBMs provide are...


More Articles

Healthcare Leaders Reveal Concerns About Generative AI, Ransomware

by Kyle Murphy, PhD

Today’s top stories focus on leading cybersecurity concerns, new nursing home standards, and troubling findings about behavioral health access. Generative AI and Ransomware Top Cybersecurity...

Healthcare Costs Hurting Individuals and the US Healthcare System

by Kyle Murphy, PhD

Today’s roundup focuses on pricing disparities of drugs and hospital services, the burden of medical debt on middle-class Americans, and the financial implications of data breaches caused by...

Many Telehealth Providers Facing Impractical Patient Expectations

by Kyle Murphy, PhD

Telehealth was instrumental to the healthcare industry's response to the coronavirus pandemic, but telehealth providers are coming face to face with unrealistic patient expectations, leading to...

Primary Care Physician Turnover Tied to Increased Healthcare Spending

by Kyle Murphy, PhD

The continued strain on the healthcare system is driving physicians out of practice and new findings suggest that primary care physician turnover has a large financial effect on healthcare...

Temporary Staff Key to Addressing Healthcare Staffing Crisis

by Kyle Murphy, PhD

Temporary medical professionals are helping the healthcare industry paper over the cracks caused by the pandemic's strain on providers, putting in doubt the industry's ability to restore...

Medicare FFS Telehealth Visits Eclipsed 52.7 Million in 2020

by Kyle Murphy, PhD

What is the future of telehealth for Medicare beneficiaries? Data shows utilization skyrocketed between 2019 and 2020. Medicare Telehealth Use Reached New Heights in 2020 In one year, telehealth...

How Does the Healthcare Industry Lower Prescription Drug Spending?

by Emily Sokol, MPH

The exponential cost of prescription drugs has long been a debate in the United States. While many solutions have been proposed, few have been successful. From rate negotiations to pricing cap limits, no strategy to cut prescription drug...

Anthem, Kroger Partner for Medicare Advantage; CMS Overspends on Generic Drugs

by Kyle Murphy, PhD

In the modern-day take on A Tale of Two Cities, the threat of COVID-19 has become a matter of where you live, putting clearly in harm's way those without the power to be vaccinated or avoid the...

Marketing Linked to Billions in Medicare Drug Spending; AHA to Square Off Against HHS Before SCOTUS

by Kyle Murphy, PhD

Welcome back to work after a long (and for many in the Northeast rainy) weekend. Direct-to-consumer marketing appears to be paying off for pharma companies as far as Medicare drug spending is...

GoodRx Boosts Billions in Savings for American Consumers; Epic Systems Gains Traction in Population Health Management Technology

by Kyle Murphy, PhD

In perhaps a wake-up call to pharmaceutical companies, pharmacy benefit managers, and payers, data from GoodRx shows that its platform has generated $30 billion in savings for consumers to date. In...

DOJ Targets Telefraud; CMS Delays Value-Based Drug Payments

by Emily Sokol, MPH

As the DOJ sets its eyes on COVID-19-related telefraud, CMS called for public comments on delaying value-based drug payment rules. Meanwhile, a new Senate bill proposes expanding VA mental health...

Why Separating Prescription Drug Benefits Does Not Reduce Costs

by Emily Sokol, MPH

Integrating pharmacy and medical benefits drives down costs for employer groups, Highmark Inc. verified through three separate studies. And Sarah Marche, senior vice president of pharmacy services at...

Do Not Sell or Share My Personal Information
©2012-2024 TechTarget, Inc. Xtelligent Healthcare Media is a division of TechTarget. All rights reserved. HealthITAnalytics.com is published by Xtelligent Healthcare Media a division of TechTarget.