Recent media coverage on high drug prices continues to obscure the primary role drug manufacturers play in the high cost of prescription medications. Get the facts here 👇
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I work with CFO's and HR Leaders who understand the Potential of a High-Performance Health Plan and are ready to 'Get More and Pay Less' | Attract & Retain | Mitigate Compliance Risk
This article does a good job highlighting the opportunity plan sponsors have to manage their prescription drug spend. It explains that plan sponsors that self-insure have more options at their disposal than those who are fully insured. These are all good recommendations: 1️⃣ Leverage Technology 2️⃣ Manage Plans Carefully 3️⃣ Find the Right Partners 4️⃣ Take Advantage of Disruptions to the Status Quo I'd like to elaborate on the fact that the largest national insurance providers and their embedded PBM partners have the ability to do this better than anyone else. However, the misaligned incentives and commitment to maximize profits over people prevent them from doing so. Plan sponsors must be conscience of the part their trusted partners play in the perpetual price increases and lack of assistance insurers provide in helping their clients and their members manage the Rx spend. And let's not forget that some of the costliest medications are not pharmacy claims, but rather medical claims because of the way they are sourced or administered.
Prescription Drug Prices Are on the Rise. How Can Employers Manage?
shrm.org
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The ever-changing trends of prescription drug pricing are becoming increasingly complex, especially for self-funded plans. Read this latest article by my colleague to learn how employers can navigate these trends and offer the best solutions for their business. #MarshMMA #prescriptiondrug
LinkedIn Article: Decoding 2023 Rx Drug Pricing Trends: Challenges & Solutions for Self-Funded Companies
linkedin.com
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Employers, How can you continue to allow what is public knowledge and consider yourself acting in a fiduciary manner on behalf of your employees, company and stockholders???? Please contact me to discuss how our fiduciary options can help you regain your fiduciary responsibilities. mmincy@us-rxcare.com #CEO #COO #CFO #CHRO #CAA #Fiduciary #DoTheRightThing
PBMs are supposed to be the superheroes fighting high drug prices, but perverse incentives often make actual low prices their kryptonite. Kudos to the New York Times for a complete undressing of our dysfunctional prescription drug marketplace.
The Opaque Industry Secretly Inflating Prices for Prescription Drugs
https://www.nytimes.com
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Have you heard about the Trillium Drug Program? It is an annual provincial government program for residents of Ontario who have a valid Ontario Health Card and spend a large part of their income on prescription medications. The TDP provides benefits for certain prescription drugs when drug costs for a household are higher than approximately four percent of the household income or total net household income. The Trillium Drug Program covers the cost of about 5,000 prescription drugs that are currently available through the Ontario Drug Benefit program, and about 1,000 drug products upon meeting specified criteria through the Exceptional Access Program. To look up any prescription medications, you can view the Formulary online here: https://lnkd.in/gPf3dTaN You should apply to the TDP if: · Your household spends a large portion of its income on prescriptions, · You have a valid Ontario Health Card, and · Your household does not have a private insurance plan that covers prescription drugs, or your private insurance plan does not cover all the costs of your household’s prescription drugs. For more information and details on how to apply. https://lnkd.in/gyrerN5v #healthcare #medication #prescriptiondrugs #financialassistance #trilliumdrugplan #benefits #healthbenefits
Get help with high prescription drug costs
ontario.ca
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Congrats to the NYT's authors Robbins and Abelson for releasing this first article on the middlemen in the business of pharmacy that is slowly and methodically dismantling independents and chains! For 30 years at least, pharmacy associations and organizations have been trying to make changes to laws both state and federal, so these behemoth organizations can be reined in. The pharmacy business is difficult to understand; the details glaze over the eyes of legislators not to mention Human Resource officers and CFO's of major corporations. Now, our country has begun to experience pharmacy deserts due to PBM abuses. Closings of chain locations started to get some attention. What will people do? How will they get their prescriptions? Medicare has requirements for geographic coverage for patients...what will happen now that so many pharmacies are refusing to fill for $0.00? Will the FTC finally step in and do the job they started 2 years ago? All of us in the business of pharmacy certainly hope so. Maybe this article will light the fire!
PBMs are supposed to be the superheroes fighting high drug prices, but perverse incentives often make actual low prices their kryptonite. Kudos to the New York Times for a complete undressing of our dysfunctional prescription drug marketplace.
The Opaque Industry Secretly Inflating Prices for Prescription Drugs
https://www.nytimes.com
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Senior risk management and actuarial advisor leveraging my experiences as a Chief Risk Officer and Chief Actuary to provide solutions to problems facing my clients
This is a good, quick read addressing the mark-ups of being applied to specialty drug infusions. #selffunded #humanresources #reinsurance #insurancebrokers
Study shows that hospitals impose major price markups on cancer and other specialty drugs - UC Berkeley Public Health
https://publichealth.berkeley.edu
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Interesting article! Please read!
PBMs are supposed to be the superheroes fighting high drug prices, but perverse incentives often make actual low prices their kryptonite. Kudos to the New York Times for a complete undressing of our dysfunctional prescription drug marketplace.
The Opaque Industry Secretly Inflating Prices for Prescription Drugs
https://www.nytimes.com
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Corporate Health Benefits Expert • Youth Coach • Pre-Dawn Exercise Freak! Though I’m passionate about all three, it’s your company’s benefits I’d like to focus on here.
Why do your prescription drugs cost so much? Are you struggling to afford your prescriptions - or do they just seem to cost more than they did in the past? Check out this article as it has some good tips to help you lower your spend at the pharmacy. It also discusses reasons for the high costs of prescription drugs in America and some of the solutions. Yes, there are ways to tame the beast. The private sector and good old competition seem to be doing a good job. Some Pharmacy Benefit Managers are bucking the system and driving down costs. The better news is we can help you take advantage of what they do. #PMB #prescriptiondrugcosts #competition https://loom.ly/dAAv8eE
Why do your prescription drugs cost so much? - Harvard Health
health.harvard.edu
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CVS Pharmacy is introducing changes to how its prescription drug pricing model works. Here's what you need to know. 💊CVS said it will role out a new reimbursement model designed to make costs more predictable at the drugstore counter. 💊This new model involves a formula based on the cost of the drug, a set markup and then a fee for filling the prescription. 💊CVS drugstores will start using this model next year but it will be more broadly available in 2025. #cvshealth #cvspharmacy #healthcare
CVS Health lays out changes to clarify prescription drug pricing that may save some customers money
apnews.com
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The New York Times recently published a detailed explanation of how PBMs drive drug costs up across the board. Pharmacy benefit managers (#PBMs) sometimes create significant barriers to the adoption of some innovative or even generic or biosimilar drugs, due to their incentives to keep patients on drugs that maximize their own profit. These middlemen, who manage prescriptions for over 200 million Americans, have merged and grown into major healthcare conglomerates. Instead of reducing drug costs, they often inflate them by pushing higher-cost medications, adding steep markups, and collecting hidden fees. We need to address the issue of economic incentives within the industry’s supply chain if we want to reduce drug costs and ensure affordable access to medications. I recently wrote about this issue in the context of Humira and its biosimilar alternatives, which you can find on my website. I highly recommend everyone to give the full article a read; it’s especially enlightening for those who are not in the industry and would like to learn more about drug pricing: https://lnkd.in/g3D-bKC4
The Opaque Industry Secretly Inflating Prices for Prescription Drugs
https://www.nytimes.com
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