On May 18, 2016, the Department of Health and Human Services (“HHS”) published a final rule to implement Section 1557 of the Affordable Care Act (“ACA”), which prohibits discrimination in health coverage and care based on race, color, national origin, age, disability and sex. These provisions incorporate existing federal non-discrimination law and policy and also […]
One of the most important contractual elements in a Pharmacy Benefit Manager’s (“PBM”) service agreement that is used in pharmacy benefit cost reduction is the definition and utilization of the MAC (“Maximum Allowable Cost”) list. The MAC generally refers to a PBM-generated list of products that includes the upper limit or maximum amount that a […]
PBM Consulting – Do You Know Your Total Specialty Drug Spend?
November 16, 2015
Uncategorized
By now most prescription drug plan sponsors have seen the growing impact of specialty drugs on their health plan’s benefit budget. Reducing prescription drug costs requires a strategic and tactical plan to tackle the problem. Specialty drugs continue to blow the roof off of prescription drug cost trend estimates. 2014 saw specialty trends at 27% […]
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7 Crucial Tips
Here are 7 Crucial Tips you'll want to know to reduce your Drug Spend in your PBM Contract.
