Mandatory Electronic Prescribing of Controlled Substances (EPCS) Can Help Combat the Opioid Crisis
April 04, 2018
According to government estimates, the opioid epidemic has reached crisis proportions, and now costs the US more than $500 billion...
PBMs and payers are committed to the affordability and sustainability of the healthcare system and recognize the importance of aligning reimbursement around value instead of volume. Traditionally, risk-sharing agreements between payers and drug manufacturers have not been tied to the value that medications provide. However, the use of real-world clinical and financial outcomes are driving the acceleration of value alignment.
Value and outcomes-based contracts are being developed for drugs that have quantifiable, widely accepted outcomes metrics. Data collected to inform these contracts continue to provide doctors and payers with unique insights that enhance clinical decision-making processes and increase competition across the marketplace.
Broader adoption of value-based contracting requires trust, collaboration, and a willingness to explore new pricing models. In the midst of increasing expenditures, PBMs are asking manufacturers to stand by their products in the real world and leverage the use of specialty pharmacies to provide the right support to patients and providers. By paying for only what works through value and outcomes-based contracts, payers can lower overall costs and preserve valuable resources to fund future innovations in the drug pipeline.
Mandatory Electronic Prescribing of Controlled Substances (EPCS) Can Help Combat the Opioid Crisis
April 04, 2018
According to government estimates, the opioid epidemic has reached crisis proportions, and now costs the US more than $500 billion...
PCMA Member Survey: The Impact of POS Rebates and POS Pharmacy DIR
March 27, 2018
The Pharmaceutical Care Management Association (PCMA) had an independent third party conduct a survey of its members to assess the...
Milliman Analysis: Medicare Part D Program Characteristics that Affect Plan Sponsor Gain/Loss Margin
March 16, 2018
The Medicare Part D program has regulatory requirements and competitive dynamics that affect plan sponsor gain/(loss) margin. The Pharmaceutical Care...
PCMA Statement on Oversight Committee Hearing on EpiPen Price Hikes
September 21, 2016
(Washington, D.C.) —Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt issued the following statement on today’s House Committee...
September 20, 2016
A new report, “Comparison of Hepatitis C Treatment Costs,” shows Hepatitis C drug prices, specifically negotiated by pharmacy benefit managers...
PCMA on New PwC Report: PBMs Driving Competition to Reduce Drug Costs
June 21, 2016
(Washington, D.C.) — The new PwC Health Research Institute (HRI) annual report (“Medical Cost Trend: Behind the Numbers 2017”) highlights...
How one man unintentionally overdosed every day on blood thinners
June 01, 2016
Aetna — Half of heart disease patients don’t take their medications as recommended. As a result, they end up in...
Cigna Reaches Pay-for-Performance Deals for PCSK9 Inhibitors
May 11, 2016
American Journal of Managed Care — The health insurer Cigna has reached agreements with makers of both approved versions of...
Health Care Experts Explore Value-Based Drug Pricing
May 05, 2016
CVS Health — Should prescription drugs be priced based on how well they work? Tying drug pricing to value is...
Oncology Care: Controlling Costs, Improving Value and Enhancing Care
January 30, 2016
CVS Health — In recent years, unprecedented strides in oncology care have been made – with many treatment options now...