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Health Solutions

Prescription drugs

We help navigate pharmacy benefit challenges

Overview

Milliman prescription drugs solutions

PBM contracting and management

Pharmacy plan design

Medicare Part D

Medicare Part D

Insight

Milliman prescription drugs insight

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A payer’s guide to weight-loss medications

The glucagon-like peptide-1 (GLP-1) receptor agonist drug class—which includes diabetes drugs Wegovy and Ozempic—is proving effective at managing obesity, leading to surging demand.

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Article

Medicare Prescription Payment Plan: What do plan sponsors need to know?

Health plan sponsors need to understand the mechanics of the Medicare Prescription Payment Plan and prepare for the program’s operational complexity.

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White paper

PBM Best Practices Series: Pharmacy benefit claims auditing

When seeking ways to keep expenses under control, plan sponsors may overlook the value of claims auditing.....

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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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Article

Maximizing opportunities to efficiently manage pharmacy costs in Medicaid

As drug costs continue to rise, states need to engage in strategies that include policy and nonpolicy options to manage prescription spending in Medicaid.

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Article

PBM Best Practices Series: Clinical programs and value-based decision-making

A review of best practices for plan sponsors in evaluating clinical programs offered by pharmacy benefit managers.

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Article

PBM Best Practices Series: Effective contracting

One of the most important ways plan sponsors can lower healthcare costs without significantly changing their benefits is to look for opportunities to improve their pharmacy benefit manager (PBM) contract.

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Article

PBM Best Practices series: Rebate audit services

Auditing the administration of the pharmaceutical manufacturer rebate program, including dollars paid, is a proven strategy for improving plan sponsor profitability, prescription drug affordability, and the management of pharmacy benefit manager contracts.

White Paper

PBM Best Practices Series: Carve-in vs carve-out programs

Employers and other plan sponsors have the option of carving in or carving out their pharmacy benefit program from medical benefits. Which strategy is right for you?

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