Discussions
If Medicare for All Won’t Work, What Possibly Can?
Some election-year topics are hotter than others, and now that impeachment seems to be behind us, many expect that the topic of health care access will heat up. Not that this hasn’t gained plenty of press and airtime in the past few months. The Democratic presidential...
If Mandatory Bundled Payments Save Little, What Will?
It is well known that the cost for specific procedures in US hospitals is not only far higher than in most Western countries, but it may be far greater from hospital to hospital in the same geographic area. And this may not include an apples-to-apples comparison of...
How Can Health Plans and PBMs Escape the “Rebate Trap”?
The rebates given to pharmacy benefit managers to secure a drug’s place on the formulary have become a difficult barrier to coverage for new products. The rebate income for these PBMs is sometimes passed on to health plans, insurers, and employer purchasers, but more...
How Economic Value Became a Big Part of a P&T Committee’s Considerations Today
Years ago, the undeclared rule of law was that a Pharmacy and Therapeutics (P&T) Committee’s deliberations must be free of cost concerns. This rule is increasingly being overturned. The P&T Committee, as a formulary decision-making body, was supposed to decide...
Controversy Over the Cost to Bring New Drugs to Market
This is one of the prickliest topics in the health care industry, and it has been as long as I can remember. One of the publications I worked with was called Product Management Today. Long defunct, this periodical followed the pharmaceutical industry quite closely. As...
A Merger and a Turning Point for Pharmacy Practice?
The federal government agreed on October 10 that the Aetna and CVS Health merger can be consummated. That deal came with the caveat that the sale of Aetna’s Medicare part D business to WellCare is finalized. Internal relationships between managed care plans and...
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