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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.

Efficacy within reach

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?

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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.

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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.

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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.

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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.

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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.

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WHITE PAPER

Payer strategies for GLP-1 medications for weight loss

We examine various strategies related to GLP-1 medications such as Wegovy when used for weight loss to help payers understand the landscape, develop a coverage strategy, and minimize waste.
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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.

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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.

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An end to manufacturer rebates as we know them today?

What do Part D plan sponsors need to consider when rebates cease to exist?

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A new Part D benefit design?

Prescription Drug Pricing Reduction Act proposes major changes to Part D

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Ask the tough questions. We’re ready for them.

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Ask the tough questions. We’re ready for them.

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