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Tip of the Week: Do’s and Don’ts of PBM RFPs

Post author:Tyrone Squires, MBA, CPBS
Post published:December 9, 2020
Post comments:0 Comments

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ABOUT THE AUTHOR

Tyrone Squires, CPBS is author of The Employer’s Guide Blog to Overseeing PBMs. Mr. Squires is Founder and Managing Director of TransparentRx , the first fiduciary model PBM, and lead lecturer for the Certified Pharmacy Benefits Specialist (CPBS) program. A course which offers, SHRM, HRCI, pharmacists and L&H licensees up to 20 hours of continuing education. Read More.

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April (6)

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September (6)

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eVouchers Circumvent Benefit Designs to Get High-Cost Brand Drugs Dispensed [Rerun]
Satisfaction With Pharmacy Benefits Managers Hits 9-Year Low [Weekly Roundup]
A Holistic Approach to Drug Therapy Optimization for Employers and Patients
CEO thinks more payers will leave traditional PBMs behind [Weekly Roundup]
Drug Utilization Management Programs: Exploring Benefits and Challenges

October (5)

Pharmacy Benefit Questions to Ask for HR
Copay Accumulators: Implications for PBMs and Health Plans After Court Strikes Down HHS Rule [Weekly Roundup]
Unlocking the Power of Net Promoter Score (NPS) in the PBM Industry
Employers take tougher measures because of rising health costs [Weekly Roundup]
Trends in Compensation of PBMs and PBM Contracting Entities

November (8)

Hospitals are dropping Medicare Advantage plans left and right [Weekly Roundup]
PBM Copay Accumulator Programs: Employers Must Prepare for Changes
PBMs Should Brace for a Copay Accumulator Program Shift [Weekly Roundup]
Pharmacy Benefit Institute of America Celebrates Outstanding Achievements of New CPBS Graduates
Plan Sponsors Have a Fiduciary Duty to Employees that Includes Scrutiny of PBM-Owned Rebate Aggregators [Weekly Roundup]
5 Strategies for Employers to Address Social Determinants of Health (SDOH)
Pharmacy Benefit Managers: History, Business Practices, Economics, and Policy [Weekly Roundup]
TransparentRx Recognized in the Prestigious 7th Annual Vet100 List

December (4)

Employer Health Plans Fear State PBM Crackdown Preemption Threat [Weekly Roundup]
Navigating the Waters of Stop-Loss Insurance
CMS Letter to Pharmacy Benefit Management Companies [Weekly Roundup]
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January (12)

Billionaire Mark Cuban steps up assault on US prescription drug prices, or is he just another player in the mail-order pharmacy market? [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 398)
Tip of the Week: eVouchers help circumvent health plan sponsor benefit designs to get high-cost brand drugs dispensed
Issues Arise as Health Plans Begin Covering At-Home COVID-19 Tests [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 397)
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Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 396)
The Chief Medical Officer for CVS Caremark Said What?!
CMS Plans to Regulate Pharmacy Benefit Manager DIR Fees [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 395)
Tip of the Week: Copay Accumulator Programs are Bad for Business

February (11)

New study claims hospitals charge double for specialty drugs compared to pharmacies [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 402)
Every Health Care Plan Sponsor Must Have a System in Place to Make Sure Drugs Work [Tip of the Week]
How Pharmacy Benefit Managers Make Money and What To Do About It [Free Webinar]
New Exposé Reveals Pharmacy Benefit Manager Tactics That Hurt Patients, Providers, Employers, and Taxpayers [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 401)
PBMs ranked by market share: CVS Caremark is No. 1 [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 400)
4 Little Known Ways to Optimize Drug Spend [Tip of the Week]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 399)
How Pharmacy Benefit Managers Make Money and What To Do About It [Free Webinar]

March (6)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 405)
How Pharmacy Benefit Managers Make Money and What To Do About It [Free Webinar]
5 Best Methods to Counter Fraud, Waste and Abuse in Pharmacy Benefits
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 404)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 403)
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April (12)

Copay Coupons Charity or a Bribe? [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 409)
PBM Formulary Management Tips: Three That Are Meaningful
Court Rules in Favor of Cigna Over Anthem in $14.8B PBM Drug Overcharge Claim [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 408)
Prior Authorization for Prescription Drugs What You Should Now
Average Wholesale Price (AWP) 3 Reasons Why It is Misunderstood
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 407)
Court Rules in Favor of Cigna Over Anthem in $14.8B PBM Drug Overcharge Claim
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 406)
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May (14)

How Pharmacy Benefit Managers Make Money and What to Do About It [Free Webinar]
Anti-competitive PBM Practices Harming Patients, Payers, and Pharmacies, APCI Tells FTC [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 413)
6 PBM Performance Metrics to Hang Your Hat On
CMS Medicaid Copay Rule Struck Down by Federal Judge, Handing Drugmakers Major Win [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 412)
5 Questions to Ask PBM Finalists Before Announcing the Winner of a Competitive Bidding Process
Trends in Specialty Benefit Design Report Published by PSG [Weekly Roundup]
Generic Substitution Rate (GSR) and Employer-Sponsored Prescription Drug Costs
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Johnson and Johnson sues SaveOnSP for allegedly overusing drug cost assistance program [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 410)
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How Pharmacy Benefit Managers Make Money and What to Do About It [Free Webinar]

June (13)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 418)
Prescription Drug Pricing Isn’t The Problem. Bloomberg Law Has It Wrong.
Formulary Steering Prevents Members from Accessing Generics [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 417)
How Pharmacy Benefit Managers (PBM) Make Money
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Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 416)
PBM Formulary Management Tips: Three That Are Meaningful [Rerun]
6 Payor Tactics to Control Drug Spending [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 415)
Benefits of Working with a Fiduciary Model PBM [Free Webinar]
6 Payor Tactics to Control Drug Spending [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 414)

July (14)

Pharmacogenomics is Increasingly Relevant [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 422)
Is Drug Importation a Valid Prescription?
Doctors use more brand drugs when on the pharma dole [Weekly Roundup]
Simplifying Medical Benefit Drug Management Complexities [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 421)
5 Things To Do Immediately About Drivers Of Pharmacy Costs
How specialty drug ‘solution stacking’ can rein in pharmacy benefit costs [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 420)
Three Reasons Why the PBM Transparency Act Won’t Reduce Drug Costs
Florida Takes Additional Actions to Lower Prescription Drug Prices [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 419)
“Big Three” PBM and National Association of Chain Drug Stores (NACDS) Part Ways
300 drugs now in generic ‘cartel’ probe [Weekly Roundup]

August (9)

Is self-funding the solution to growing medical and drug costs? [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 426)
Newly launched U.S. drugs head toward record-high prices [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 425)
Pharmacy Benefit Managers Falsely Use DAW Codes
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 424)
Biosimilars shake up US drug market in 2023 and beyond [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 423)
How Pharmacy Benefit Managers Make Money and What to Do About It [Free Webinar]

September (9)

Three Underappreciated Reasons for Micromanaging Pharmacy Benefits
How PBMs Make Money and What to Do About It [Free Webinar]
2023 Large Employers’ Health Care Strategy and Plan Design Survey [Weekly Roundup]
The Conventional PBM RFP Process Is Flawed – Here’s the #1 Way to Fix It
PBM Ordered to Pay Aids Healthcare Foundation (AHF) $23 million [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 428)
6 Indicators Your PBM is Hoarding Rebates
4 PBM Trends to Watch — And, Yes, Transparency is One of Them [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 427)

October (6)

6 Things Every Transparent PBM Should Do for Clients
How the 10 largest PBMs hold huge sway in health care marketplace [Weekly Roundup]
New Report Clears Up Misunderstandings About Drug Pricing Benchmarks
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November (7)

FDA Approves $3.5 Million Gene Therapy to Treat Adults with Hemophilia B
What do Ticketmaster and Pharmacy Benefit Managers have in common? [Weekly Roundup]
FTC reaffirms commitment to unfair business practices
Consolidated Appropriations Act shifts more responsibility to employers next year [Weekly Roundup]
PBM Revenue Streams that are Bad for Customers
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December (8)

How Coupons Keep Drugs Costly [Weekly Roundup]
Ask PBMs These 8 Questions
Americans are Becoming Sicker Because of Rising Prescription Drug Costs [Weekly Roundup]
6 Indicators Your PBM is Hoarding Rebates [Rerun]
Self-funded plans sue health care company alleging overcharging and other ERISA violations [Weekly Roundup]
How PBMs Make Money and What to Do About It [Free Webinar]
Type 2 Diabetes Drug is Hollywood’s Latest Diet Craze [Weekly Roundup]
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2021 (128)

January (7)

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[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 349)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 348)
Tuesday Tip of the Week: It is a Myth That Any Pharmacy Benefit Manager Offers Better Price Savings Because of Their Size
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 347)
Tuesday Tip of the Week: Expanded Drug Lists are an Excessive Pharmacy Cost Driver

February (9)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 354)
Tuesday Tip of the Week: 3 Ways Savings Could be Achieved by Improving Pharmacy Benefit Design and Management (Rerun)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 353)
Tuesday Tip of the Week: Optimize Specialty Contracting to Control Costs and Improve Patient Outcomes
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 352)
Tuesday Tip of the Week: Money is Good, Information is Better
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 351)
Auditor Claims Non-Fiduciary Pharmacy Benefit Manager Hiked Drug Prices by $1.6 million with Rebate Credit Program
Tuesday Tip of the Week: Drug Manufacturer Rebates Have Never Been the Problem

March (11)

Tip of the Week: Pass-Through and Transparent PBM Business Models are Small Ideas (Re-run)
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 358)
Tuesday Tip of the Week: It is a Myth That Any Pharmacy Benefit Manager Offers Better Price Savings Because of Their Size (Rerun)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 357)
Tuesday Tip of the Week: Don’t Turn a Blind Eye to PBM Management Fees
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 356)
Tuesday Tip of the Week: PBM’s are the Only Check on Drug Manufacturers’ Ability to Increase Drug Costs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 355)
Tuesday Tip of the Week: Vertically Integrated Insurers Pivot to Protect Drug Manufacturer Revenue
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money

April (9)

AIDS Healthcare Foundation Taking Tough Stance on PBMs – Pharmacy Benefit Manipulators, Really?
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 363)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 362)
Tuesday Tip of the Week: 8 Considerations During Annual PBM Reviews
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 361)
Tuesday Tip of the Week: PBMs are Under Attack But Commercial Employers Get Little Help
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 360)
Tuesday Tip of the Week: Benefits of Working with a Fiduciary-Model PBM
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 359)

May (12)

The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 367)
Tip of the Week: Claims Repricings Should Not Be Your Most Important Tool in Evaluating PBM Proposals
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 366)
Tip of the Week: Money is good, Information is better [rerun]
Large PBM Under Fire for Not Accurately Disclosing the True Cost of its PBM Services
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 365)
What’s Worse Than Overpaying for Pharmacy Benefits? Believing You Aren’t.
Tuesday Tip of the Week: How Pharmacy Benefit Managers Make Money [Video]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 364)
Tuesday Tip of the Week: Dig Deeper into Your Non-Fiduciary PBM’s Financial Shenanigans
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money

June (10)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 372)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 371)
AIDS Healthcare Foundation (AHF) Files Federal Antitrust Lawsuit Against BUCA PBM
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 370)
Mississippi AG Files Lawsuit Against Insulin Manufacturers and PBMs over Insulin Pricing Scheme
PBM Agrees to Pay a Record $88.3 Million to Settle Ohio Case
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 369)
Tuesday Tip of the Week: Specialty Drugs Have Taken Over
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 368)
Tip of the Week: Smaller PBMs Grade Higher on Customer Satisfaction

July (11)

The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 374)
Tip of the Week: Non-Fiduciary PBMs Hedge Against Their Legacy Business Models
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 374)
Tip of the Week: The Specialty Drug Pipeline Will Make You Rethink Your Pharmacy Benefits Management Strategy
Costco approach could have saved Medicare $2.6 billion in drug spending, analysis shows
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 373)
Tip of the Week: Fiduciary Model Pharmacy Benefit Managers (PBM) are a Thing
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 373)
Tip of the Week: Pharmaceutical Manufacturers are Light Years Ahead of Commercial and Public Sector Employers, Unions, Health Plans and Health Systems
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money

August (11)

Tip of the Week: How to Eliminate Huge PBM Markups and Reduce Pharmacy Costs by 50%
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 378)
Tip of the Week: Drugmakers circumvent health plan sponsor benefit designs, at the switch, to get high-cost brand drugs dispensed
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 377)
Ohio awards contract worth billions to the same company it accused of fraud and was later paid $88 million as a result
10 Definitions, Related to Prescription Drug Prices, All Purchasers of PBM Services Should Know
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 376)
Tip of the Week: The health plan sponsor hiring a PBM always has the final say on contract terms
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 375)
Tip of the Week: Education is the most logical and effective foundation for achieving maximum value in pharmacy benefit management (PBM) services.

September (10)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 382)
Tip of the Week: Specialty Drugs Have Taken Over (Rerun)
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 381)
Tip of the Week: What is spread pricing, and how does it affect a PBM’s revenues?
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 380)
Tip of the Week: How PBMs Help Rein in Drug Spending
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 379)
Tip of the Week: A Good Formulary is the Backbone of an Efficient Pharmacy Benefit Program
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 379)

October (13)

Just because a drug is approved by the FDA, does not mean it has proof of efficacy [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 386)
Three surefire ways to know if your PBM is overcharging you
An attorney shares the warning signs of ‘self-serving’ PBMs [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 385)
Self-funded employers have a corporate responsibility to understand MAC lists
Average Specialty Drug Price Reached $84,442 in 2020, Rising More Than Three Times Faster Than the Prices of Other Goods and Services [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 384)
Tip of the Week: How Pharmacy Benefit Managers Make Money [On-Demand Video]
Kansas audited its $80 million prescription plan, but it’s still shrouded in mystery [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 383)
Tip of the Week: Claims Repricings as the Primary Tool in Evaluating PBM Proposals is Like Buying a Used Car Without Ever Looking Under the Hood [Rerun]
How PBM “rebate walls” impact drug spending, patient care and competition [Weekly Roundup]

November (14)

Tip of the Week: Don’t Opt-Out of Step Therapy Programs
Pharmacy and PBM Leader Deloitte Consulting: Specialty Drugs Rely on Personalization for Optimal Outcomes [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 390)
Tip of the Week: How Hospitals and Specialty Pharmacies Get Paid – The 340B Math
Medicaid Specialty Drug Trend Finally Surpasses 50% of Pharmacy Spend in Most Recent Pharmacy Trend Report [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 389)
Tip of the Week: PBMs that make money through hidden cash flows do so at the expense of client savings and health of members
Private insurers pay steep markups for hospital drugs [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 388)
Tip of the Week: Three Undervalued PBM Performance Metrics
Employer strategies to manage costs for rare diseases [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 387)
Tip of the Week: How drugmakers circumvent benefit designs to get high-cost brand drugs dispensed [Rerun]
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]

December (11)

DIR fees from PBMs increased by 91,500% in just 9 years [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 394)
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 393)
The Consolidated Appropriations Act (CAA) Introduces Broker Compensation Transparency [Weekly Roundup]
Tip of the Week: Think Twice Before Joining a PBM Drug Pricing Coalition (rerun)
Understanding the Evolving Business Models and Revenue of Pharmacy Benefit Managers [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 392)
Tip of the Week: Think Twice Before Joining a PBM Drug Pricing Coalition
Pharmacy Benefit Managers are Outwitting Attempts at Accountability, Tougher Rules [Weekly Roundup]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 391)

2020 (137)

January (12)

New Report: Health Plans, PBMs, Employers, and Health Systems Keep $166B in Rebates and Discounts Provided by Drugmakers
Physician Practices Must Create a System to Deal with PBM Drug Denials
PBM 101 Webinar: How to Slash PBM Service Fees, up to 50%, Without Reducing Benefits or Shifting Costs to Employees
Self-Insured Employers Turning to PBMs to Fight Prescription Drug Abuse
Infographic: 6 Reasons a Small PBM is as Good as a Big PBM
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 301)
U.S. Supreme Court to hear case on States’ Right to Regulate Pharmacy Benefit Managers (PBM)
PBM 101 Webinar: How to Slash PBM Service Fees, up to 50%, Without Changing Vendors or Member Benefit Levels
Drawing a Line in the Sand California Looks to Contract Directly with Generic Drug Manufacturers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 300)
Chief Economist Writes, “Constraining Pharmacy Benefit Managers Will Not Reduce Drug Prices”
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 299)

February (8)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 303)
The ROI on Pharmacy Benefit Management Services; New Study from PCMA
Tip of the Week: For your next PBM request for proposal ditch email and paper
Value-Based Contracts Slowly Picking Up Steam
3 ways PBMs can team up with employers to save on specialty drugs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 302)
Tip of the Week: Don’t Give Up Leverage to PBMs
New report alleges that pharmacy benefit managers (PBMs) in Florida are favoring their own affiliated pharmacies

March (13)

Tuesday Tip of the Week: Avoid “Bargain Basement” PBM Administration fees
PBM Evaluation Process: Is Yours Up to Par?
Gross-to-Net Bubble: Brand Drug List Prices Increase 159% and Net Prices 60% from 2007 to 2018
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 306)
Tuesday Tip of the Week: Maximize DUM Programs to Manage Costs of Specialty Pharmaceuticals
American Pharmacist Association (APhA) Issues Prescription Drug Supply Guidance for Patients and Caregivers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 305)
Tuesday Tip of the Week: Get Your Contract Definitions in Order
Non-Fiduciary PBMs Arbitrarily Designate Certain Drugs as “Specialty” Medications
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 304)
Large Employer Groups Push Back on Non-Fiduciary PBMs and Win Big!
Don’t Miss Webinar: How to Slash PBM Service Fees, up to 50%, Without Reducing Benefits or Shifting Costs to Employees
Patient Assistance Programs: A Shield from High Cost or Trampoline for Abuse?

April (12)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 311)
Formulary Exclusions are Gaining Popularity
Tuesday Tip of the Week: You Should Not Pay a PBM for Your Own Claims Data
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 310)
Tuesday Tip of the Week: A PBM Proposing Anything Short of Full Disclosure is a Non-Starter
What is the CPBS credential? A podcast with Erin L. Albert, JD, PharmD
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 309)
Tuesday Tip of the Week: Who is Watching the Watcher?
How the Pharmacy Benefit Management Industry is Reacting to COVID-19
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 308)
Tuesday Tip of the Week: One Year PBM Service Agreements are not a Fail-Safe
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 307)

May (11)

The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 315)
Tuesday Tip of the Week: There are no problems associated with pharmacy costs a PBM consultant can solve that a PBM, if it so chooses, can’t itself solve for self-funded employers
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 314)
6 Pillars of Pharmacy Benefit Plan Design (Rerun)
Tuesday Tip of the Week: Price Isn’t the Only Driver of Pharmacy Costs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 313)
Tuesday Tip of the Week: Take DAW 9 Off the Table for Non-Fiduciary PBMs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 312)
Tuesday Tip of the Week: PBMs Must be Fiduciaries
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]

June (11)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 319)
The Untold Truth: How Pharmacy Benefit Managers Make Money [Free Webinar]
Tuesday Tip of the Week: 3 Common Places PBM Overcharges Occur
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 318)
Specialty Drugs: A Five Pillar Approach to Managing Cost
Tuesday Tip of the Week: Spreadsheets as the Primary Tool in Evaluating PBM Proposals is Like Buying a Used Car Without Ever Looking Under the Hood
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 317)
Tuesday Tip of the Week: Lead with Transparency or a Non-Fiduciary PBM’s Pricing Analyst will Exploit Your Lack of Sophistication
BCBS Insurers in Six States Sue CVS Health Over an Alleged Scheme to Overcharge Them for Generic Drugs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 316)
Tuesday Tip of the Week: Large non-fiduciary PBMs hire members of the Big Four consulting firms to help them identify ways to generate hidden cash flows

July (12)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 324)
Tuesday Tip of the Week: Deadlines get deals done
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 323)
Tuesday Tip of the Week: Dose Optimization Interventions Yield Significant Specialty Drug Cost Savings
Channel Management for Specialty: Challenges with Medical Benefit or Pharmacy Benefit
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 322)
Tuesday Tip of the Week: When the carrier, PBM and ASO all share the same parent company you are fully insured
Potential Specialty Generic Drugs 2020
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 321)
Tip of the Week: Pass-Through and Transparent PBM Business Models are Small Ideas
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 320)
Tuesday Tip of the Week: 3 Ways to Prepare for the Inevitable Rise in Pharmacy Benefit Costs

August (11)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 328)
Tuesday Tip of the Week: Out-of-pocket caps don’t lead to increased health plan spending or reduced affordability for all enrollees
Free Webinar | The Untold Truth: How Pharmacy Benefit Managers Make Money
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 327)
Tuesday Tip of the Week: Factor Benefit Design into your PBM Scorecard
Pharmacy CEO pleads guilty to $50M reimbursement fraud
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 326)
Tuesday Tip of the Week: If I were a plan sponsor here are the seven things I would be asking of PBMs during an RFP
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 325)
Free Webinar | The Untold Truth: How Pharmacy Benefit Managers Make Money
Tuesday Tip of the Week: Put a Stake in Vampiric PBM Management Fees

September (11)

Tuesday Tip of the Week: PBMs can be Fiduciaries
Drugmakers Push Back on the Use of Contract Pharmacies by 340B Covered Entities
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 332)
Free Webinar | The Untold Truth: How Pharmacy Benefit Managers Make Money
Tuesday Tip of the Week: Focus on Lowest Net Cost Drugs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 331)
Tuesday Tip of the Week: Increase out-of-pocket (OOP) spending for specialty drugs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 330)
Tuesday Tip of the Week: When the carrier, PBM and ASO all share the same parent company you are fully insured (Rerun)
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 329)
Tuesday Tip of the Week: 6 Reasons a Small PBM is as Good as a Big PBM

October (12)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 337)
[Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money
Tuesday Tip of the Week: Factor Benefit Design into your PBM Scorecard (Rerun)
Bling-Loving Postal Boss Asked to Step Down Over $12,000 Worth of Cartier Watches
Dean Foods Carves Out Specialty Pharmacy and Saves Big
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 336)
Tip of the Week: Self-insured Employers Must Draw a Line in the Sand between them and Non-fiduciary Pharmacy Benefit Managers
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 335)
Tuesday Tip of the Week: Institute new contract terms that do not permit spread pricing
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 334)
Tuesday Tip of the Week: 3 Ways Savings Could be Achieved by Improving Pharmacy Benefit Design and Management
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 333)

November (10)

Ohio Requesting Bids for Administrator to Oversee its Pharmacy Benefit Program
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 341)
Tuesday Tip of the Week: Non-Fiduciary PBM Rent-Seeking Behavior Eliminates Their Price Advantage
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 340)
Tuesday Tip of the Week: 6 Reasons a Small PBM is as Good as a Big PBM [Rerun]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 339)
Tuesday Tip of the Week: Specialty Drug Utilization Management Three Things to Know
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 338)
Tuesday Tip of the Week: Three Myths about PBM Pricing Every Employer-Sponsored Plan Should Know

December (14)

Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 346)
Study Finds Non-Fiduciary PBMs are Draining Florida’s Medicaid Funds
Internal Email Shows Big Three PBM Was Overcharging – And Knew It
[Free Webinar] The Untold Truth: How Pharmacy Benefit Managers Make Money
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 345)
Tuesday Tip of the Week: Commercial Employers Pay More Than Public Sector Employers in Spread Pricing
Self-Funded Employers: Your Generic Dispense Rate (GDR) Should be 90% or Higher
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 344)
Tuesday Tip of the Week: The Untold Truth How Non-Fiduciary PBMs Make Money [Volume 153]
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 343)
What is a Copay Accumulator Program and How Does It Work?
Tip of the Week: Do’s and Don’ts of PBM RFPs
Reference Pricing: “Gross” Invoice Cost vs. AWP for Popular Generic and Brand Prescription Drugs (Volume 342)
Tuesday Tip of the Week: 3 Ways for Employers and HR Pros to Know If They Have Selected the Right Insurance Broker for Pharmacy Benefits

2019 (141)

January (12)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 256)
Big Pharma is Slow to Allow Health Outcomes to Dictate Pricing — At Least For Now
Outcomes-Based Contracting for Prescription Drugs is Set to Accelerate
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 255)
Access to Drug Cost Data Before Leaving the Doctor’s Office
Employers are Sticking it to Employees, with Rebates, for a Couple of Dollars in Savings
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 254)
CVS makes dubious case for rebates’ impact on drug prices
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 253)
Turns out CVS’s “New” Guaranteed Net Cost Pricing Model is More of the Same – That is Bait and Switch
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 252)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

February (7)

How to Save $1.6 Million Bucks: 5 Tips for Cutting Specialty Pharmacy Costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 259)
How Self-Funded Employers Leave Employees Holding the Bag: The Copay Clawback Phenomenon:
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 258)
A Closer Look into the Popular Pricing Benchmark: Average Wholesale Price (AWP)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 257)
Ohio’s State Auditor Just Released its Full Report on PBM Transparency and You Won’t Believe Your Eyes

March (13)

Electronic Prior Authorizations (ePA) Save Plan Sponsors Time and Money
Understanding the Complexity of DIR Fees
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 263)
Robbing Peter to Pay Paul: Co-Pay Accumulator Programs Could be Doing More Harm Than Good
Smaller independent pharmacies consistently offer cheaper options than chain pharmacies
Don’t look now but things are getting even more complicated: Point-of-sale discounts (rebates) to consumers as part of employer-sponsored plan design
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 262)
A Lack of Competition Leads to Brand Drug Price Increases
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 261)
Uncovering Hidden Specialty Drug Spend Outside of the Pharmacy Benefit
Eli Lilly and Company to Offer Generic Insulin at 50% Off Brand Name Humalog
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 260)

April (10)

Copay Accumulator Programs Now Allowed by CMS to Encourage Switch to Generic Drugs
Ohio’s Attorney General Calls for PBMs to Operate as Fiduciaries
Are specialty drug pricing spreads the new money pit vis-a-vis rebates?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 266)
Short fills eliminate medication waste and reduces costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 265)
Cross-walk HCPCS codes to NDC codes for granular medical benefit drug claim (MBDC) information
Bureau of Securities Releases Rule to Impose Fiduciary Duty on Brokers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 264)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

May (11)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 270)
Good Options To Help Self-Insured Employers Improve PBM Contracting Efficiency
Kentucky Report: “Opening the Black Box” Reveals Non-Fiduciary PBMs Took Home $123 Million From Spread Pricing
Sweeping Health Care Legislation Proposal Calls for Disclosure of Perks and Fees Paid to Health Benefits Brokers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 269)
Elimination of PBM Gag Clauses Allow Independent Pharmacies to Save Patients Money on Prescription Drugs
Top 7 Reasons the PBM Industry is Ripe for Disruption
Here’s one reason why prescription drug prices are so high: the fix is in!
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 268)
“The Big Payback” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 267)

June (11)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 273)
Help is on the way: Federal lawsuit accuses generic drug makers of using “code” to fix price increases
AARP Report: Specialty Drug Prices Soar to Nearly $79,000 per Year
Another opaque PBM contract bites the dust
Could proposed rebate rule be a once-in-a-generation opportunity to reset our system to work better?
Ohio Cancels Bad PBM Contracts and Quickly Gets a Better Deal
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 272)
Massachusetts Health Policy Commission report: Non-fiduciary PBMs are driving up health care costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 271)
“The Big Payback” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
CVS’s Push Into Your Doctor’s Office

July (13)

Trump Administration ‘Opens Pathway’ on Drug Imports From Canada
Impact of a Co-pay Accumulator Adjustment Program on Specialty Drug Adherence
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 277)
Flow of the Specialty Drug Dollar: A Business Process Model with Notation
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 276)
DIR fees in Medicare Part D grew by 45,000% between 2010 and 2017
The White House Yanks Proposed Drug Rebate Overhaul
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 275)
Largest pharmacy benefits manager in the U.S. accused of costing the New York City Transit Authority tens of millions of dollars
Court Declines to Enforce Indemnification Provision Against Negligent Pharmacy Benefits Manager
UnitedHealth’s PBM unit, Optum, tops $100 billion in revenues for the first time
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 274)
State’s attempt to curb pharmacy benefit manager service fees mostly futile

August (13)

Pension Funds Sue Insulin Manufacturer for $1.75 Billion over Alleged Collusion
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 282)
PBM 101 Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Targeted Medication Reviews (TMRs) Critical Success Factor for Medication Therapy Management
Op-ed: PBMs are Driving Up Costs and Lowering Quality Care in America
Self-funded employers spend 40% of costs on less than 1% of prescriptions
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 281)
How an Stand-alone PBM Uses Patient Engagement to Improve Cost and Patient Outcomes
Medicare and its beneficiaries could have saved an estimated $17.7 billion if older generics were prescribed, study finds
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 280)
Plan Sponsors Laser Focused on High-Cost Claims
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 279)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 278)

September (12)

Milton Friedman’s Shareholder Theory Is Wrong Afterall
How to Assess the Value of Cell and Gene Therapies: ICER’s Founder
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 286)
Can Formulary Management Bring Specialty Drug Spend Back Down to Earth?
AARP Rx Price Watch Report Shows Prescription Drug Prices Increase by Double the Rate of Inflation
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 285)
Special Report: Reducing Wasteful Spending in Employers’ Pharmacy Benefit Plans
Oncologists Getting 6% of Drug Price Is ‘Financial Conflict’
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 284)
Site of Care Management: Administering specialty drugs outside hospitals could save $4 billion
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 283)
Opinion Editorial: A reckoning is coming for non-fiduciary PBMs

October (10)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 290)
New York Firefighters Association Cracks Down on Non-Fiduciary Pharmacy Benefit Managers
Prime Therapeutics Study: Number of ‘Drug Super Spenders’ Grew 63% In 3 Years
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 289)
Wasteful Spending in Healthcare Estimated at $760B to $935B
Michigan wants to save $40 million by cutting non-fiduciary PBMs out of Medicaid
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 288)
Courts Look Closely at the Contractual Relationship Between Plan Sponsor and PBM
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 287)
New prescription drug pricing system reins in non-fiduciary pharmacy benefit managers

November (13)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 295)
OptumRx overcharged Ohio BWC by millions, Attorney General says
A Prominent Attorney and Advocate for PBM Transparency Says State Medicaid Plan Hemorrhaging Money
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 294)
American College of Physicians Position Paper: Recommendations for PBMs to Stem the Escalating Costs of Prescription Drugs
California is Carving Out Pharmacy Benefits
AARP has released a new Rx Price Watch report
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 293)
Holy cow! Diplomat Pharmacy is a shell of its former self
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 292)
Benefits Alert: Chronological Timeline of Prescription Drug Copay Accumulator Programs
Infusing Radical Transparency into PBM Contracts
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 291)

December (16)

Reducing Wasteful Spending in Employers’ Pharmacy Benefit Plans; Special Report (Rerun)
Wasteful Spending: Check out the price tags on combination prescription drugs
BCBS of Tennessee will stop reimbursing providers for certain specialty drugs typically administered in a doctor’s office or hospital setting
Feds Finally Release Proposed Drug Importation Policies
U.S. Pharmacy Reimbursement and Distribution System (Rerun)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 298)
Doctors Prescribe More of a Drug If They Receive Money from a Pharma Company Tied to It
Express Scripts to handle drug rebate negotiations, on the pharmacy benefit, for Prime Therapeutics
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 297)
Researchers find surgery for blocked arteries is often unnecessary
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 296)
Geesh! UnitedHealth’s Optum paying $300 million for Diplomat specialty pharmacy
Specialty Generic and Biosimilar Drug Pipeline Update
PBM 101 Webinar: How to Slash PBM Service Fees, up to 50%, Without Reducing Benefits or Shifting Costs to Employees
Generic Drug Pipeline Update
In 2020, Optum To Provide More Than 50% Of UnitedHealth’s Total Company Earnings

2018 (142)

January (13)

Lawmakers Seek Transparency in 340B Program
FDA Approved Record-Breaking Number of Generics in 2017
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 203)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 202)
Why pharmaceutical companies, under attack for drug prices, started an industry war
Health care deals could make you healthier but may not save you money
Maryland Group Challenges Pharmacist Gag Clause on Drug Costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 201)
The Death of Objectivity
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 200)
Drug prices rise as big pharma profit soars
More transparency on generic drug acquisition cost data could save $4 billion

February (11)

Hidden Profits In the Prescription Drug Supply Chain
7 techniques to blunt specialty drug costs hardly any self-insured employer is doing right or at all
What might the Amazon, Berkshire and JP Morgan health care joint venture actually do?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 207)
Prescription Drug Coupons: A One-Size-Fits-All Policy Approach Doesn’t Fit The Evidence
Biosimilars Are Not “Generic” Versions Of Expensive Biologic Medicines
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 206)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 205)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Top 8 Specialty Drug Categories Driving Spending in 2018
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 204)

March (14)

What’s your decision flow process?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 212)
Clinical Reviews | An underused way to save big on pharmacy benefits
U.S. spending on drugs will grow faster than on other health-care services over the next decade
10 Steps to Improving Your Company’s Pharmacy Benefit Management Results
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 211)
Fiduciary PBMs emerge as response to consolidation of Rx dispensing, concern over conficts of interest and need for deeper clinical expertise
Generic Hepatitis C Drugs Begin to Emerge
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 210)
6 Pillars of Pharmacy Benefit Plan Design
A costly PBM trick: set lower copays for expensive brand-name drugs than for generics
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 209)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 208)

April (13)

Therapeutic Interchange: How It Could Affect Patients and Plan Sponsors
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 216)
The role of PBMs in the drug supply chain — and why it matters to employers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 215)
Amazon About-Face On Drug Sales Not Surprising To Walgreens And CVS
The Price of Non-Optimized Medication Therapy
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 214)
Two Generic Medications Become One Cash Cow Drug
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
When left to their own accord, non-fiduciary PBMs will act in their own self-interest
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 213)
Newer Specialty Drugs Require Payers to Revise Coverage Strategies
Standing pat can’t be a long-term strategy for self-insured employers

May (12)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 221)
Amgen, AbbVie ‘ahead of the crowd’ in fighting payers’ latest assault on copay coupons
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 220)
Trump’s Drug Blueprint Could Alter PBM Contracting
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 219)
Appellate court kills Optum’s $6.7B pharmacy benefits management contract; orders rebid
From $14000 to $8000 Overnight with Almost No Restrictions; Cholesterol Drug has Potential to Break Self-Insured Employers’ Bank
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 218)
Longtime chief of pharmacy benefit manager trade group to step down
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 217)
ESI Reachs Deal on Struggling Cholesterol Drug with a List Price Over $8000
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

June (11)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 225)
What is a fair share? Pharmacy middlemen made $223.7M from Ohio Medicaid
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 224)
Dereliction of Fiduciary Duties by CFOs and HR Execs Triggering Department of Labor Investigations
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 223)
3 strategies for reducing pharmacy costs
State Rx law cut down on appeal; benefits manager group prevails in federal panel ruling
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 222)
Mergers between health insurers and pharmacy benefit managers could be bad for your health
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Why CVS Loves ObamaCare

July (12)

FDA Biosimilar Plan Offers Employers Saving Strategy Solution
Meet the Rebate, the New Villain of High Drug Prices
Million-dollar+ medical claims increase 87 percent from 2014-2017: Sun Life report
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 229)
The Bezos-Buffett-Dimon health care venture: Eliminate the middlemen
Department of Health and Human Services (HHS) Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 228)
Amazon’s PillPack deal puts PBMs, advisers on notice
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 227)
IFEBP provides tips on managing specialty drugs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 226)
Clawbacks: Settling the score with non-fiduciary pharmacy benefit managers

August (13)

BCBS of Tennessee: Prescription Drugs Have Become the Single Leading Cost Driver
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 234)
Is consolidation in health care good for employers?
Three Ways to Avoid Bankrupting Costs for Medical Spend J Code Drugs
Large PBM is staking out million-dollar gene therapies
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 233)
Auditor’s Report: Pharmacy Benefit Managers Take Fees of 31% on Generic Drugs Worth $208M in One-Year Period
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 232)
Ohio Medicaid pulls the plug on contracts with two big PBMs over ‘spread’ pricing
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 231)
Secret discounts paid by drugmakers to pharmacy benefit managers are going away so now what?
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 230)

September (12)

Abolishing Drug Rebates May Push Consumer Drug Costs Higher
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 238)
Gilead to launch generic versions of its hepatitis drugs
Fiduciary rule revival: Should it apply to pharmacy benefits managers?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 237)
Why third-party payers are gobbling up PBMs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 236)
The Marriott Rewards Program and Non-Fiduciary PBMs have a lot in common
The Secret Drug Pricing System Middlemen Use to Rake in Millions
Health Plan with 495,000 Covered Lives Says Prescription Medications Account For One in Four Dollars Spent
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 235)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

October (10)

Most employers (60%) aren’t tracking wasteful healthcare spending
PepsiCo and ExxonMobil Team Up with Express Scripts to Create Pharmacy Benefit Design for Radical Transparency and Greater Performance Accountability
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 242)
UnitedHealth has bought another billion-dollar pharmacy business
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 241)
Another big PBM has confirmed it’s primary objective isn’t to contain prescription drug costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 240)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 239)
A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

November (11)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 247)
4 Key Factors Employers Must Consider When Evaluating Specialty Pharmacy Performance
State Settles $500k Dispute with a Big Three Pharmacy Benefits Manager
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 246)
Express Scripts announces “new” formulary that favors lower-cost generics
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 245)
Achievement is Significant But Comes with a Huge Price Tag: New Regulation Requires Regulatory Oversight of Pharmacy Benefit Managers (“PBMs”)
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 244)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Unless Your Company Has Money to Burn Don’t Ignore These 7 PBM Contract Pitfalls
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 243)

December (10)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 251)
Are Biosimilars the Future of Specialty Pharmacy?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 250)
Pennsylvania’s Auditor General Demands PBM Contracting Transparency
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 249)
Ninety-Two Percent of Self-Insured Companies Lack a Formalized Pharmacy Benefits Management Process
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 248)
CVS Health launches “New” Guaranteed Net Cost Pricing Model
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Union takes to task pharmaceutical manufacturer on a $6,000,000 per year specialty drug

2017 (141)

January (12)

Pharmaceutical Companies Not Seeing Majority of Drug Revenue
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 152
Diplomat Pharmacy, Inc. has published a new report on the state of specialty pharmaceuticals
Secret rebates erode drugmaker revenue, industry study says
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 151
Plan Sponsors Zero In on Specialty Pharmacy Costs in 2017 Benefits
Pharmacy Benefit Manager disclosure law preempted by federal benefits law, the U.S. Court of Appeals for the Eighth Circuit ruled
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 150
The Future of Employer-Sponsored Coverage
“Don’t Miss” webinar Tuesday January 10 at 2PM ET
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 149
Pharmacy benefit managers could be in legislative crosshairs

February (11)

Pharmacists sworn to secrecy as PBMs force customers to overpay for drugs
How to Rein In the Soaring Costs of Specialty Drugs
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 156
Key to rebate cost savings, define which drugs are actually eligible for rebates
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 155
Employers Take Extra Steps to Curb Specialty Drug Costs
Prescription Drug Pipeline: Drugmaker to Patient Explained [Infographic]
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 154
Six Takeaways: How are prescription drug prices set?
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 153

March (14)

Out-of-pocket costs based on drug list prices; a hidden fee
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 160)
How do insurance companies decide what medicines to pay for and when to pay for them?
Understanding the Villain of Big Pharma: Traditional Pharmacy Benefit Managers
Pharmacy Benefit Manager Back-end Fees Rise $13 Billion in 3 Years
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 159)
The “TROUBLES” with Pharmacy Benefit Managers
What Outcomes-Based Contracting Means For Drug Development & Drug Pricing
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 158)
Drugmaker Says Pharmacy Benefit Managers Keep Prices High
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 157
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Drug Costs Too High? Fire the Middleman
Fancy Pill-Reminder Box Isn’t Helping Patients Remember Anything

April (12)

How do manufacturer rebates impact drug prices?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 164)
Anthem, Express Scripts largest customer, will not renew its contract with the pharmacy benefit manager
Second biosimilar to Remicade approved by the FDA
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 163)
What’s your PBM IQ? Take our quiz to find out.
What to do About Rising Health Care Costs?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 162)
New Solutions for Curbing Runaway Drug Costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 161)
Prescription Drugs Account for 22% of Payer Premium Spending
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

May (11)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 169)
Behind the War Between Health Insurers and Pharmacy Benefit Managers
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 168)
Explained: Why your PBM isn’t pass-through
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 167)
A Whistle-Blower Tells of Health Insurers Bilking Medicare
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 166)
Inside the ‘Scorpion Room’ Where Drug Price Secrets Are Guarded
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 165)
California Advances PBM “Transparency” Law

June (10)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 173)
What Effect Will Anthem-Express Scripts Fallout Have on Industry?
[Video] Pharmacy Benefits Manager Explained
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 172)
How ‘price-cutting’ middlemen are making crucial drugs vastly more expensive
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 171)
In Washington, everyone is for lower drug prices, but only in theory
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 170)
Loaded Dice: How Non-Fiduciary PBMs are Winning the Cash and Rebate Game

July (12)

Unaccountable Benefit Managers: How PBMs Put Profits Over Patients
Pharmaceutical manufacturer drug coupons days may be numbered
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 177)
Large group employers are currently struggling to afford specialty drugs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 176)
This story should terrify the employee benefits and PBM industries
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 175)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Kaleo fires back at Express Scripts, claiming it’s owed at least $5.3M
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 174)
Learned Helplessness: The Biggest Reason Non-Fiduciary PBMs Getaway with Overbilling
Maryland Is First to Ban “Price Gouging” on Generic Drugs, but Other State and Federal Initiatives May Soon Follow

August (13)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 182)
Implementing Reference Pricing Led to Changes in Drug Selection, Lower Spending
Here’s how a non-fiduciary PBM controls information and pricing
Take the Generic, Patients Are Told. Until They Are Not.
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 181)
New Website Launches to Educate About DIR Fees
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 180)
Express Scripts’ profit grows despite dwindling revenue from Anthem
Lawsuit against CVS could blow up what you thought you knew about drug prices
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 179)
What’s your PBM IQ? Test your pharmacy benefits competency.
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 178)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

September (12)

Impact of Biosimilar Approvals on the Pharmaceutical Market
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 186)
Cost Containment Strategies and Vendor Contracting Employers’ Top Health Plan Concerns
Pfizer Files Lawsuit Against J&J, Claiming Anticompetitive Practices
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 185)
New Hep C Pricing Model: A Game Changer for Self-Funded Employers
Insurers cutting back on drug coupons amid concerns over consumer costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 184)
PBMs Look to the Future
PBM’s and More: In A World of Cost Plus, Is Transparency a Dirty Word?
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 183)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels

October (12)

Only 30% of Employers Get Pharmacy Benefit Manager Contracts
Taking a More Active Role: The Main Ingredient for Controlling Prescription Drug Costs
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 190)
The Top 200 Prescription and Non-Prescription Drugs, by volume, of 2017
Anthem, CVS Health sign 5-year deal for a new PBM dealing a blow to Express Scripts
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 189)
Formulary Management: Don’t Allow the Fox to Guard the Henhouse
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 188)
The Spread and I’m not talking about Miracle Whip
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 187)
Hospital Impact—Pharmacy benefit managers are a lot like car dealers

November (12)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 195)
Non-Fiduciary Pharmacy Benefit Managers: The Sopranos of the Pharmaceutical Industry
Specialty Drugs Paid Under Medical Benefit Circumvent Cost Control Measures
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 194)
OptumRx is now caught up in the court battle between Anthem and Express Scripts
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 193)
Reverse Auction Helps New Jersey Save $1.6 Billion on Prescription Drugs
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 192)
Controversy heats up over pharmacy benefit manager DIR fees
PBM Service Fees: The One Topic Which Rarely Comes Up During Contract Negotiations
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 191)

December (10)

Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 199)
CVS-Aetna merger is a robber baron’s dream come true
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 198)
CVS-Aetna Merger Will Influence Employers’ Benefits Decisions: Aon
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 197)
Consultants warn ‘change or get out of the way’ next year
Prescription Drugs May Cost More With Insurance Than Without It
Reference Pricing: “Gross” Invoice Cost for Popular Generic and Brand Prescription Drugs (Volume 196)
“Don’t Miss” Webinar: How to Slash PBM Service Costs, up to 50%, Without Changing Vendors or Benefit Levels
CVS buying Aetna in deal valued at $69 billion

2016 (132)

January (11)

Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 103)
Employers Turn to Deductibles, Out-of-Pocket (OOP) Limits to Manage Prescription Drug Costs
Despite Obamacare, prescription drug discount cards are still relevant
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 102)
With coupon programs, drug industry hides ballooning costs of expensive new medicines
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 101)
Anthem seeks $3B more in drug savings from Express Scripts
Prescription Drug Launch Forecast – 2016
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 100)
How Pfizer set the cost of its new drug at $9,850 a month
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 99)

February (11)

Employers Take Aim to Curb High Cost of Pharmacy Benefits
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 107)
Economists Debate: Fight With or Adapt to Rising Drug Prices?
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 106)
PBM Tools Play Key Role in Managing Specialty Drug Costs
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 105)
Hospitals launch specialty pharmacies to curb drug costs
PBMs Provide Policy Solutions to Reduce Rx Costs, Increase Competition
NCPA to Congress: Scrutinize PBM Corporations as Part of Drug Cost Review
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 104)
New York requires PBM contracts to include dispute resolution provisions

March (14)

Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 112)
Stemming the Escalating Cost of Prescription Drugs: A Position Paper of the American College of Physicians
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 111)
Unbundling the Secrets of Managing Drug Costs in the Era of Value-Based Care
Employers scramble to keep lid on climbing specialty drug costs
More Large Employers Self-funding Pharmacy Benefit Plans
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 110)
Surprise proposal: Medicare wants to jump on the value-based prescription drug pricing bandwagon
For Pharmacy Benefits, Is Greater Choice Always Better?
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 109)
Employers testing new ways to rein in specialty drug costs
Drug distribution becomes a weapon to block competition
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 108)
Employers Doubling Down on Pharmacy Costs

April (11)

Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 116)
Express Scripts generates top-line revenue of $76.63 per claim!
Game of Thrones: Express Scripts Holding Company Countersues Anthem
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 115)
Shining a Light on the Dark Practice of Rx Price Gouging
Center for Medicare and Medicaid Services New Plan to Curb Medicare Prescription Drug Price Inflation
National Drug Spend | $310B in 2015 and projected to double by 2020
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 114)
Recent Trends in Prescription Drug Costs
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 113)
OptumRx and Walgreens to partner on 90-day prescriptions

May (10)

Specialty Pharmacy Spending Continues to Grow
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 120)
1 Number From CVS Health That Blew Me Away
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 119)
High cost or high value? Specialty pharmaceuticals add to employers’ health care costs
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 118)
U.S. Investigates Drugmaker Contracts With Pharmacy Benefit Managers
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 117)
[VIDEO] Why Your PBM’s Business Model Matters
High-cost specialty drugs; predictions for the future

June (12)

Express Scripts, Anthem Face ERISA Lawsuit Over Drug Pricing
Workplaces Fight Skyrocketing Prescription Drug Costs
Review vs Audit: A Comparison of Services Performed by Pharmacy Benefit Management Consultants
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 124)
The 7 Habits Of Highly Effective Benefits Professionals
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 123)
Drug companies fight generics with coupons
Pharmacy Benefit Managers offer a commodity. Do not treat them as differentiated services.
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 122)
UHC administered self-insured health plan, AT&T, sued in federal court for embezzlement, self-dealing in medical claims overpayment offset dispute
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 121)
Concerns Persist about the 340B Discount Program

July (10)

Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 128)
Employers falling short on managing healthcare costs
Reference Pricing: “Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 127)
Anthem, Express Scripts dispute comes down to pricing…as should all PBM service agreements
Back-billing: an opaque process which significantly increases plan sponsors’ pharmacy costs
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 126)
10 Essential Facts About Medicare and Prescription Drug Spending
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 125)
Hold middlemen’s feet to the fire to cauterize specialty drug spending
Decoding Big Pharma’s Secret Drug Pricing Practices

August (12)

Reference Pricing: Actual Acquisition Cost (AAC) for Top Selling Generic and Brand Prescription Drugs – Volume 132
Hand caught in cookie jar, United Healthcare changing drug overpayment program
New Report Identifies Most Expensive Specialty Drugs
Who is getting rich from the price of prescription drugs?
Reference Pricing: Invoice Cost (Gross) for Top Selling Generic and Brand Prescription Drugs – Volume 131
Solutions for Reducing Patient Cost Sharing for Prescription Medications
Should drug prices be tied to patient outcomes?
Reference Pricing: Invoice Cost (Gross) for Top Selling Generic and Brand Prescription Drugs – Volume 130
In-Office Dispensing: A Better Value?
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 129)
Big companies form an alliance to find ways to reduce pharmacy costs
A Path Forward for Lowering Prescription Drug Prices

September (11)

“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 137
Can ‘Pay for Performance’ Control High Drug Prices?
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 136
[Video] PBMs | Bigger Doesn’t Mean Better
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 135
Chicken Soup for the Self-Funded Employer: Foolproof PBM Contracts
One slide from my “don’t miss” webinar Tuesday September 13 at 3:00 PM ET
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 134
[Podcast] Rx Drugs and the U.S. Health System – A Conversation About Drug Prices
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 133
The co-pay card debate simmers, as payers push back

October (10)

“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 141
Survey supports transparency of drug pricing by pharmacy benefit managers
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 140
Employers Overpay 10-50% on Health Benefits: Time for a Second Opinion
Pipeline to Profits: How Drug Middlemen Make Money
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 139
Insulin costs are way up, but drugmakers say PBMs are collecting the loot
One slide from my “don’t miss” webinar Tuesday October 11 at 3:30 PM ET
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 138
Drugmakers Point Finger at Middlemen for Rising Drug Prices

November (9)

Side Effects: The new role of PBMs [VIDEO]
A Sick Calculation About Prescription Drugs
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 144
Minnesota Department of Health finds drugs given in medical settings are big drivers of costs
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 143
Claims Analysis: Negotiated Pricing Between Preferred and Non-Preferred Retail Pharmacies
PAs (prior authorization) work, if done right
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 142
[Podcast] Rx Drugs and the U.S. Health System – A Conversation about Election-Cycle Proposals for Lowering Costs

December (11)

High-Priced Drugs: Estimates of Annual Per-Patient Expenditures for 150 Specialty Medications [Report]
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 148
Top pharmacy challenges of 2017
Pharmacy benefits: Super-sized, minimized or right-sized?
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 147
Pay-for-performance drug pricing: drugmakers asked to eat costs when products don’t deliver
“Don’t Miss” webinar Tuesday December 13 at 2PM ET
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 146
Drugmaker sheds light on path of rebate dollars
Integrating pharmacy benefit, medical benefit cuts costs
“Gross” Invoice Cost for Top Selling Generic and Brand Prescription Drugs – Volume 145

2015 (101)

January (8)

Top 10 trends shaping the health industry in 2015
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Drug Distributors Build Strength In An Era Of Change
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Prevent prescription drug monopolies
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Specialty Drug Approvals: Review 2014 and a Forecast for 2015
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs

February (9)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Mild to aggressive; remedies for reducing prescription drug prices
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Specialty Pharmacy: The Top 10 Trends Payers Should Be Following
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Generic drug price hikes hit pharmacists and payers
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
[Infographic] The Cost of Innovation: How Specialty Drugs Impact Healthcare
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs

March (8)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Should Specialty Drugs Be Shifted From Medical to Pharmacy Benefit?
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
When It Comes to New Drugs, If Providers and Payers Snooze, They Lose
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
[Video] The Challenge of Getting Specialty Drugs from Manufacturer to Patient
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
The Makings of a Good Drug Formulary

April (8)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Proof: The People PBMs Hire to Hide Cash Flow From Employers
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
6 ways to lower healthcare spend vis-à-vis specialty pharmacy
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
5 Keys to Managing Your Company’s Pharmacy Benefit in a Dynamic Health Care Marketplace
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
The malevolence of all health care sectors

May (9)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
New Push Ties Cost of Drugs to How Well They Work
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Why do pharmacy benefit managers (PBMs) overcharge their clients?
Price vs Patient Access: Specialty’s Unsettling Conundrum
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Rare Look: A Detailed Analysis of an Existing Client’s Old Contract with a Legacy Pharmacy Benefits Manager
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
The Rise of Speciality Drugs: Is Your Health Plan Prepared?

June (8)

Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
125 Things to Know About the ‘Big 5’ Insurers
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
The Curious Incident of the $44,000 Prescription
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
OIG Highlights Anti-Kickback Risks of Drug Co-payment Coupons
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Pharmacy Discount Cards: Scam or Savings?

July (10)

Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
Employers Use of Multi-Tier Pharmacy Benefits Continues to Rise
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
Emerging Trends in the Specialty Drug Market
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
Will Specialty Oncology Products Follow the Sovaldi Way?
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
Controlling Pharmacy Costs
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs
Time to Blow Up Your PBM Strategy — Here’s How

August (8)

Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 82)
Specialty Drug Costs Prompt Employers to Tighten Their Belts
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 81)
Large Employers Look To Tighten Control Of Costs For Expensive Drugs
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 80)
Pharmacy Podcast Show – The Fiduciary PBM
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 79)
Shocker: CVS Allegedly Overcharged Employers (Payers) for Prescription Drugs

September (9)

How the national drug debate is changing the pharmacy benefit business
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 86)
Can payers and plan sponsors be held responsible for questionable pharmacy benefit manager practices?
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 85)
Studies try to help pill regimen adherence
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 84)
Rising Cost Of Drugs: Where Do We Go From Here?
Reference Pricing: “Net” Ingredient Cost for Top Selling Generic and Brand Prescription Drugs (Volume 83)
State In Legal Battle Over Prescription Drug Benefits

October (8)

Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 91)
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 90)
Some multi-source (generic) prescription drugs cost roughly as much as their brand name rivals: Here’s why
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 89)
Building the In-house Pharmacy Benefit: Three considerations for the health system as plan sponsor
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 88)
For Prescription Drug Makers, Price Increases Drive Revenue
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 87)

November (9)

Specialty drugs in the pipeline: 4 heavily impacted diseases
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 95)
Amgen Agrees to Pay-for-Performance Deal With Harvard Pilgrim Health Care Plan
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 94)
Payers: Forget specialty drug costs—generic prices are crushing our budgets, too
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 93)
PBMs wed with promise of savings, but reduction in choice may hurt employers
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 92)
How self-funded employers can tackle double-digit prescription drug cost increases

December (7)

Drug Prices Are Too Damn High. Here’s How to Fix Them
Employers Battle Drug Costs
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 98)
Who Has the Power to Cut Drug Prices? Employers.
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 97)
Prescription Drug Spending For State Employees Runs Wild, Despite Cost-Saving Efforts
Reference Pricing: “Net” Invoice Cost for Top Selling Generic and Brand Prescription Drugs (Volume 96)

2014 (80)

January (7)

2014 Launch Forecast for Generic Prescription Drugs
Reference Pricing: Pharmacy Invoice Cost for Top Selling Generic and Brand Prescription Drugs
The Pharmacy Benefits Manager RFP; 7 Contract Tips for a Cost Efficient Drug Benefit Design
Pharmacy Cost [invoice] for Top Selling Brand and Generic Prescription Drugs
PBMs and generic drugs: Is the good news ending?
Pharmacy Invoice Prices (Actual) for Top Selling Generic and Brand Prescription Drugs
Mail order drug systems more cost effective than brick-n-mortar pharmacies

February (7)

CMS Proposed Rules on Medicare Part D
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Limited Pharmacy Networks are Changing Employer Sponsored Prescription Drug Benefits
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Pharmacy Network Reimbursement Rates
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs

March (7)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Eight Reasons Employers Overpay For PBM Services
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
What is the True Cost of PBM Services?
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Do drug benefit managers reduce health costs?
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs

April (6)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Early Pharmacy Claims Data from Exchange Enrollees Indicate High Usage
[Video]: Prices Soaring for Specialty Drugs
Experts warn employers to prepare for high costs of specialty drugs
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Lawmakers seek more pricing info from PBMs

May (6)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Video: Specialty Drug Pricing Discussion on Nightly Business Report
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Plan Sponsors’ Satisfaction With PBMs Remains Relatively Unchanged
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
IMS Report: Specialty Medications Drive Prescription Drug Spending Increase

June (7)

2014 Generic Prescription Drug Launch Forecast
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Average Wholesale Price (AWP) for Twelve of the Most Expensive Specialty Drugs
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Industry Consolidation Is Impacting PBM Customer Service
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
The Insurance Industry is Picking a Fight with Pharmaceutical Companies Over the Rising Cost of Specialty Drugs

July (8)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Reality Check: US Consumer Drug Costs Climb Ever Higher
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Restrictive formularies: A path to more affordable drug prices
Specialty Drugs: A Proactive Approach to Sustained Cost Containment
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
2015 Generic Prescription Drug Launch Forecast
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs

August (6)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Prescription drug tiers can’t handle all budget woes, study shows
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
2014 Generic Prescription Drug Launch Forecast [UPDATED]
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Insurance Industry, Consumers Join Forces to Fight High Prices of Specialty Drugs

September (8)

Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
States step in to regulate drug copays
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Drug prices soar as Big Pharma targets discount program
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
10 Things To Know About Specialty Drug Spending
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
2015 Generic Prescription Drug Launch Forecast [UPDATED]

October (9)

Friction Between Health Plans, Pharma Grows Over Specialty Drugs
Pharmacy Carve-Out: 7 Benefits for Self-Funded or Fully Insured Employers
Repackaging: A “Traditional” Pharmacy Benefit Manager’s Black Box Tactic [Video]
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
National Health Expenditure Projections 2013-2023
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Generic Drug Field Full of Pricing Traps
Reference Pricing: Pharmacy Invoice Cost (ACTUAL) for Top Selling Generic and Brand Prescription Drugs
Can Specialty Pharmacies Ease the Pain Of Soaring Deductibles?

November (4)

5 Strategies for Managing Specialty Prescription Drug Costs
Illustrative Example of Supply Chain Pricing for Brand Name Prescription Drugs
Plan Controls Respond to PBM Spreads, Generic Cost Spikes
We Need More Transparency on the Cost of Specialty Drugs

December (5)

PBM Myth: The Request For Proposal (RFP) Binds Your Pharmacy Benefits Manager
Bitter Pill: Drugs Work But Drive Overall Cost
The Rising Cost of Generic Prescription Drugs is Even Puzzling Experts
Pressing for PBM Transparency
The Growing Turf War over Who Can Fill Prescriptions

2013 (56)

January (3)

THE FEDERAL GOVERNMENT HAS DELAYED THE EXCHANGE NOTIFICATION REQUIREMENT
U.S. Pharmacy Distribution & Reimbursement System
Agencies Offer Guidance on PPACA Taxes, Fees

February (3)

PBMs | All about the Benjamins
State-by-State Health Insurance Exchange Decisions
Why are Prescription Drugs so Darn Expensive?

March (3)

How to Control Specialty Pharmacy Costs?
The #1 Way to Cut Employer Prescription Drug Costs
Infographic: The Savings Potential of Self-Insuring

April (2)

Small Pharmacies Getting Squeeze from Goliath PBMs
Insurance Commissioner Refuses to Enforce Obamacare

May (4)

PPACA Play-or-Pay Decision Guide for Employers
After CMS Releases Chargemaster Data, Hospitals Mull Price Changes
A Federal Agency (CMS) has Requested Copies of our Purchase Invoices for Wholesale Prescription Drugs
New Report Shows Drugstore Lobby Agenda Raises Rx Costs for Small Businesses and Government Programs

June (4)

Are Employers the Culprits Behind High U.S. Health Care Prices?
Medication Adherence Infographic: Getting America to Take Its Medicine
Spending on Specialty Medications Will Rise 67%: Report
U.S. Medical Price Tag Far Higher Than Others

July (4)

Why the Fervor Over Drug Adherence?
Diabetes Drugs will Lead Specialty Category
Evolving Definition: What is a Specialty Pharmacy?
Expiring Prescription Drug Patents Benefit Consumers

August (5)

Specialty Drug Users May Feel Co-pay Pain
States Scramble to Drive Down Medicaid Drug Costs
Without action, a one-way ticket to rising drug costs
Video: Specialty Drugs are a Critical Focus for Payers
MCOs’ Shifting Control Over Office-Administered Products from Medical to Pharmacy Benefit, Particularly Affecting Rheumatoid Arthritis Therapies

September (7)

As Specialty Injectable Drug Sales Grow, Drug-Device Collaborations change the Competitive Landscape
TransparentRx Thursday: Acquisition (Pharmacy) Cost for Top Selling Generic and Brand Prescription Drugs
Fewer Employers Plan to Offer Retiree Prescription Drug Plans
TransparentRx Thursday: Acquisition (Pharmacy) Cost for Top Selling Generic and Brand Prescription Drugs
Employers Unhappy with Their Brokers
TransparentRx Thursday: Acquisition (Pharmacy) Cost for Top Selling Generic and Brand Prescription Drugs
Infographic: Are your Pharmacy Benefit Manager’s Goals Aligned with Yours?

October (8)

“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs for Payers
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs for Payers
The High Price of Specialty Drugs: Whining Won’t Solve the Problem!
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs for Payers
7 Steps for Effectively Managing Costs of Specialty Drugs
“Actual” Acquisition Costs of Top Selling Generic and Brand Prescription Drugs for Payers
Moves by Walgreens, Other Employers to Private Exchanges Create PBM Uncertainty
TransparentRx Thursday: Acquisition (Pharmacy) Cost for Top Selling Generic and Brand Prescription Drugs

November (7)

Prescription Drug Prices: 10 Definitions All Payers $hould Know
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs: for Payers
Pharmacy Benefits: Eight Ways it May Unfold in 2014
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs: for Payers
The Next BIG Thing in Prescription Drugs is in Your Pocket!
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs for Payers
Hospital helps patients manage medications, even after hospital stay

December (6)

Pharmacy Invoice Prices (Actual) for Top Selling Generic and Brand Prescription Drugs
Adviser or Broker – which standard is most beneficial to plan sponsors?
Resource for Payers: Acquisition Cost (pharmacy invoice) for Popular Brand & Generic Prescription Drugs
Payers: Know Your Prescription Drug Opportunity Costs
“Actual” Acquisition Costs (what pharmacy pays) of Top Selling Generic and Brand Prescription Drugs: for Payers
Some Patients Need Help with Medication Adherence from Pharmacists

2012 (40)

January (5)

HHS High Risk Pools Remove Restrictions and Lowers…
Fiduciary: An Appropriate Role for a PBM
Hidden Cash Flows and Pharmacy Benefit Managers
Pharmacy Benefits Manager (PBM): Traditional vs. Fiduciary
The Lover’s Quarrel: Walgreens vs. Express Script

February (3)

Pharmacy Benefits Management Glossary of Terms
10 Questions to Ask your Pharmacy Benefit Manager
What is a spread? Certainly not a Topping for Toast.

March (4)

A Cobra Exemption…
In a RFP the Whole is Greater than the Sum of its Parts
Service is an Attitude…Tips for Evaluating Brokers
Targeted for Termination? You be the Judge

April (3)

Dig Deeper: Don’t be Fooled by Fancy Titles and Terms
Informed Health Care Decisions Cut Costs & Saves Lives
Express Scripts & Medco Merger Approved, Now What?

May (4)

The Message Out of Express Script’s C-suite is Changing
Out-of-Network Benefits, the One–Two Punch
Physicians Evaluate PPACA
U.S. Health Insurers to Reimburse $1.3 Billion

June (3)

What the Healthcare Ruling really Means to Employers
Defragmentation: The Net Effect of Healthcare Reform
Rent-Seeking: A Traditional PBM’s Pathway to Riches

July (3)

Which side of the Fence are you on?
Healthcare Reform – Full Speed Ahead!
HSA vs. HRA: What are the Differences?

August (3)

Two Ways to Avoid Paying a Premium for PBM Services
Medicare Part D Deadline: October 15
PPACA: Employer Healthcare Coverage Mandate

September (2)

5 New Ways to Cut Employer Prescription Drug Costs
The Truth about Prescription Drug Discount Cards

October (4)

Telemedicine: a Step in the Right Direction
Health Insurers and the classic “Bait and Switch”
PBMs: Traditional vs Fiduciary Repricing Report (Actual)
Get your Hand out of my Pocket!

November (3)

Generic Prescription Drugs by Mail can be a Bad Deal
Healthcare Reform: “A Peek at the Cost”
It’s News to me!

December (3)

What are Affordable Care Organizations (ACOs)?
An Uncertain Future: Healthcare Reform Moves Forward
9 Key Questions to Ask Your Potential (new) PBM

2011 (2)

December (2)

PPACA: Imposes Obligations on Self-Insured Health Plans
Proposed ESI (Express Scripts Inc.) and Medco Health Solutions Inc. Merger

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