DRUG COSTS
Out of control—or delivering value?
Pharma innovation isn’t free—but few believe the sick should bear the costs. Balancing costs and benefits requires data, collaboration, and the courage to try new things.
Is affordability a pipe dream?
As drugs become more sophisticated and targeted, they often become dramatically more expensive. Even common drugs can see massive price increases when patents change hands or new uses are found.
As our healthcare systems and patients bear the cost of pharmaceuticals, how do we create a system that is fair to all—especially those whose lives could be saved by greater availability of medications?
Complexities in forecasting eligible cases and associated costs of cell and gene therapy
Beyond epidemiology, clinical trial criteria, and the science
A primer on prescription drug rebates
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How will Medicaid Pay for Cell and Gene Therapies
Amid the development of new cell and gene therapies, we present some strategies that states have used to control costs and risk among their MCOs.
The evolution of biosimilars in the United States
Biosimilars recently have made significant strides toward greater acceptance and utilization since their first U.S. approval in 2015, although challenges persist.
Commercial drug trends: 2024 release
This report provides insights into pharmacy cost and utilization trends based on our analysis of the Milliman Consolidated Health Cost Guidelines Sources Database.
Controlling Rx costs: Top 5 reasons for a PBM RFP
Five reasons why RFPs with PBMs should be a regular practice to help control Rx costs.
Impact of the Inflation Reduction Act on plans seeking creditable coverage
The Inflation Reduction Act’s higher standards for retiree prescription drug plans may require plan sponsors to enrich benefits in 2025 for creditable coverage.
Average Manufacturer Price cap removal: Implications for state Medicaid programs
As a new federal law, effective in 2024, removes a cap on manufacturers' drug rebate amounts, we explore the implications for state Medicaid programs.
Payer strategies for GLP-1 medications for weight loss
NADAC-plus: An emerging paradigm in pharmacy pricing
LWith increased consumer and regulatory scrutiny on drug prices, stakeholders in the pharmacy supply chain are exploring drug pricing alternatives.
Medicare Part D risk and claim cost changes with the Inflation Reduction Act
The Medicare Part D program is on the verge of massive change due to passage of the Inflation Reduction Act.
An end to manufacturer rebates as we know them today?
What do Part D plan sponsors need to consider when rebates cease to exist?
A new Part D benefit design?
Prescription Drug Pricing Reduction Act proposes major changes to Part D
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