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The Most Favored Nation Model and Interim Final Rule – What is this?

The rising costs of physician-administered drugs covered under Medicare Part B is one of the largest drivers of Medicare spend which have risen approximately 11.5% annually since 2015, with a total spend of approximately $30 billion in 20191. Lowering drug cost is essential to maintain Medicare for our aging population. Lowering drug prices has been […]

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“Alexa, Refill My Prescription!”

Clinical Insights, Formulary Management / Rose Mongillo, RPh

Introducing: Amazon Pharmacy….. What this launch means for the $300 billion prescription drug market and the traditional pharmacy chains currently dominating it. There are very few consumer markets where Amazon is not a leading competitor. It all started with books and e-books, then music and video streaming services, add on the ability to purchase and

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Don’t Let the Fox Guard Your Henhouse: 6 Questions to Ask Your Large National Broker

News / Michelle Frank

Pharmacy benefits are complex, seemingly on purpose. If you are with a large national broker and are utilizing their coalition PBM deal, it can be even more complex. It doesn’t have to be this way. Large brokers often have coalition deals, but these deals aren’t just for your benefit—they’re a revenue stream for the Broker

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COVID-19 Vaccine Update

Clinical Insights, Formulary Management / Rob Louie, RPh, MBA

COVID-19 has infected over 10 million people in the United States and has claimed the lives of over 237,000 people and the country’s 7-day average of new daily cases has been over 100,000. The coronavirus pandemic is continuing to wreak havoc on the health and economy in the US and in the world. Everyone is

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Cutting Through the Complexity of Biosimilars

Clinical Insights, Formulary Management / Rob Louie, RPh, MBA

The biologic drug market is huge in the US and it continues to grow at a rapid pace. However, great innovation come with greater costs. In the US, only 2% of prescriptions are written for biologic drugs, but the 2% accounted for 37% of total drug spend, which in 2018 was $125 billion in sales.

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Uncovering Solutions for Affordable Drug Pricing

Formulary Management / RemedyOne

The House Committee on Oversight and Reform held a series of hearings to review findings from an in-depth investigation into drug pricing actions that was conducted last year with CEOs representing some of the largest and most profitable pharmaceutical manufacturers. As stated in the summary report of the investigation by Chairwoman Carolyn Maloney, “the drug

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RemedyOne Drug Spotlight: Rukobia

Clinical Insights, Formulary Management / RemedyOne

Rukobia (fostemasavir) There are an estimated 2 million people living with the human immunodeficiency virus (HIV) in the United States. In 2018, there were close to 36,000 new cases of HIV diagnoses in the U.S. Since the introduction of antiretroviral therapy (ART), the HIV incidence has decreased as a result of decreased transmission and readily

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CMS’s Proposed Prescription Drug Value-Based Purchasing Rule

Formulary Management / Rose Mongillo, RPh

Paving the Way for Payment Innovation On June 17, 2020, CMS announced a proposed rule that would change how pharmaceutical manufacturers report pricing and discounts to Medicaid. The goal of this new rule is to reduce regulatory requirements that currently hinder manufacturers’ ability to enter into value-based agreements and other innovative payment models. From our perspective,

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Arbuterol 101 Plus…

Clinical Insights, Formulary Management / Rob Louie, RPh, MBA

Albuterol is a short acting beta agonist (SABA) used to treat or prevent bronchospasm in patients with reversible obstructive airway disease commonly caused by chronic bronchitis, as well as to prevent exercise-induced bronchospasm (asthma). Bronchospasms are the tightening and narrowing of the airways in the lungs causing difficulty in breathing. Exercise and other physical activity

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Acute Migraine Treatments – What’s New?

Clinical Insights, Formulary Management / Rob Louie, RPh, MBA

Migraine is a neurological disorder with severe throbbing/pulsating headache generally associated with visual disturbances, nausea, vomiting, dizziness, and sensitivity to light/sound. Migraine is often a disabling condition which affects more than 38 million people in the US. Migraine is three times more common in women than in men. Children are not immune as one out

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