Healthcare benefits

Health care plans that insist participants get their prescription medications by mail order could see backlash, unless they address concerns.

Consultants, industry groups question the transparency in PBM practices.

As CEO of United Benefit Advisors, I hear continually about the issues facing our 36,000 employer clients. Managing prescription drug costs continues to be paramount. The UBA 2012 Health Plan Survey shows that 64.2% of prescription drug plans utilize three co-pay tiers (generic, formulary brand, and non-formulary brand); 2.9% have a one-tier plan, 8.2% retain a two-tier plan; and 24.7% add a fourth tier (specialty). Consultants should watch these plan structures carefully as many brand-name drugs go off their patents and pricing is determined for the influx of generic drugs. On the other end of the spectrum, we're watching increases in specialty drugs, which are driving up costs significantly.

Manufacturers expect to produce nearly 150 million doses of flu vaccine this season, and a new report from Walgreens says the doctor’s office is the pricey place to get them.

New research suggests that reducing drug costs even a small amount for people with chronic health conditions makes it more likely they will adhere to medication regimens.

Health assistance provider CareCounsel has been purchased by Stanford Hospital & Clinics, which says leadership and core directive will not be changing.

The Generic Pharmaceutical Association claims that consumers and the health care industry have saved more than $1 trillion in the past 10 years through the use of non-name-brand meds.

New Medicare and Medicaid funding uncertainties and potential for a political stalemate on health care reform could worsen revenue growth in U.S. not-for-profit health care sector.

Experts who have crunched the numbers on retiree medical cost estimates that factor in Medicare premiums, prescription drugs and the occasional illness project frightening bills – even for healthy individuals.

In a gadget-driven world that has nearly erased any boundary line between work and life, there’s an app for just about anything. The employee benefits landscape is no exception.

For decades, health care consumers have been told once you have a problem, then you should go to the doctor. But now, as high-deductible health plans become ever more prevalent, employers are encouraging employees to go to the doctor first - before they get sick - and in turn the employer will often cover the visit at 100%.

A battle is brewing to influence public opinion over the drivers of rising prescription drug benefit costs, cost-containment strategies and the path to meaningful health care reforms.

Patients who don't take their medication as prescribed is a billion-dollar problem, reports pharmacy benefit manager Express Scripts in its 2011 Drug Trend Report. Nonadherence to prescription medication cost the U.S. health care system $317.4 billion in 2011. And that's just for treating medical complications - not the cost of lost productivity - that could have been avoided if patients had taken their medication as prescribed. The report shows that for many therapy classes, less than 50% of patients take their medication as prescribed.

The preliminary results of a pilot project involving a large, self-funded employer and a new mobile application, myDrugCosts, show that 42% of employees who used the voluntary benefit reported saving money on their prescription drug costs.

Employers want to step up programs to encourage healthier behavior among their workers and to control spending on expensive injected specialty medicines, according to a survey by pharmacy benefit manager Express Scripts Holding Co.

CVS Caremark Corp raised its full-year forecast on Wednesday after reporting a sharp rise in first-quarter sales as the drugstore operator and pharmacy benefits manager continued to win over former patrons of Walgreen stores.

A new study comparing utilization rates of patients filling 90-day prescription medications using community and mail order pharmacies found that when copays are similar, patients preferred the community pharmacy channel by a ratio of four to one.

Lawmakers are investigating three pharmacies in Maryland and North Carolina for diverting critical but scarce drugs from patients to wholesalers, who are then able to resell the medicine at sometimes big markups.

A federal judge declared last Wednesday that a Washington state rule requiring pharmacists to dispense emergency contraceptives against their religious beliefs is unconstitutional.

Objections to Express Scripts' $29 billion plan to buy rival pharmacy benefits manager Medco Health Solutions are accumulating as U.S. antitrust regulators weigh whether they have enough evidence to stop the megamerger.