Nov 25, 2024 · CVS Caremark has removed several diabetes drugs favor of newer products and generics, and is even favoring an insulin infusion system developed by a company that was cofounded by Alan Lotvin, a former executive at CVS Health.

Oct 3, 2024 · UnitedHealthcare is adding deductibles to Part D prescriptions on certain formulary tiers as a result of plan design changes from the Inflation Reduction Act.

Nov 7, 2024 · Member experience, outcomes and medication adherence are the key areas of performance that Medicare Advantage plans should focus on to improve Star Ratings.

Oct 1, 2024 · In 2025, Aetna will merge its three stand-alone prescription drug plans into a single plan and member cost-shares will be consistent at every pharmacy within its network.

Sep 16, 2024 · Prime, headquartered in Eagan, Minnesota, is one of six largest pharmacy benefit managers (PBMs) in the country, an industry that has come under increasing criticism and scrutiny for its business practices and vertical and horizontal consolidation trends. Prime acquired Magellan Rx from Centene, a Medicaid managed care company, for $1.35 billion in a deal that closed at the end of 2022 ...

Oct 9, 2024 · Premiums for employer-sponsored health insurance for families rose 7% again this year, matching the 7% increase in 2023, according to the results of KFF’s Employer Health Benefits Survey published today. Premiums for single coverage increased by 6% this year, the report said. From last year to this year, wages increased 4.5% and inflation, 3.2%, so the hike in health premium hike was ...

May 11, 2023 · Among those APMs is capitation, a payment system under which providers receive a global fee from payers for services delivered over a fixed period of time or episode of care. Capitation reimbursement models are designed to support the goals of value-based care (VBC) – improving individual and population outcomes while reducing healthcare costs. For payers, global capitation contracts ensure ...

Jan 4, 2024 · HMP Global, a healthcare education company, will acquire Drug Channels Institute. Founded in 2006 by Adam J. Fein, Ph.D., Drug Channels is a market intelligence company focused on the pharmaceutical industry. It provides webinars and industry reports on pharmaceutical economic issues and drug supply and distribution. Terms of the agreement were not disclosed. As part of the integration, Drug ...

Apr 16, 2024 · Many of the new rules Congress is considering in the still-fluid pharmacy benefit management (PBM) legislation would add reporting requirements to meet transparency goals but wouldn’t fundamentally disrupt the industry’s business practices. Not so the “delinking” provisions in some of the PBM bills that have been introduced Ross Margulies, J.D., M.P.H., a partner in the Foley Hoag law ...

Dec 9, 2024 · Suzetrigine, a non-opioid currently being reviewed by U.S. regulators to treat acute pain, would provide small savings and help patients avoid the use of opioids, according to a draft evidence report from the Institute Clinical and Economic Review (ICER). Suzetrigine is a new class of pain medicine. It targets a specific receptor, NaV1.8, that plays a role in pain signaling. Suzetrigine is ...