PBM's Fail Employers with Mail
May 9, 2007
Comparison of Mail Order with community Pharmacy Cost | www.amcp.org
Mail did not produce higher generic utilization rates or lower costs for employers who hired a PBM to accomplish both.
Media Smells Blood at Big Pharma
April 2, 2007
Under The Influence | www.cbsnews.com
60 Minutes aired its story last night on the impact of The Pharmaceutical Lobby in writing and passing Medicare Prescription Drug Plan.
Over the course of the upcoming Presidential campaign the high cost of prescription drugs will become an issue and spill over into employer plans as well with implications for PBMS and Pharmaceutical Margins.
March 28, 2007
Employers Push Health Plans to integrate Onsite Health Centers With Care Management | www.aishealth.com
Edward Deming famous quote comes to mind as I read this mornings Industry Radar about employers pushing health insurers to either run or integrate with the on-site health centers they are either running or planning. hello Health Insurers--the choice is integrate or die. At what point will many of the large managed care carriers realize their large self-funded clients will be walking for vendors capable of fully integrating their services with the strategic direction their efforts to manage health & productivity are taking? Read on
Florida Legislators Research on PBM Business Model
March 28, 2007
Legislature Could consider Options to Address PBM Business Practices | www.oppaga.state.fl.us
The attention of state legislators to PBM business practices has implications for investors in the healthcare sector as well as the business models PBMS will use in the future.
March 28, 2007
Why Generics Do not Always mean Cheap | online.wsj.com
While the Wall Street Journal has done an admirable job exposing many of the ways PBMS have boosted profits at the expense of their customers they have not yet arrived at the flaws which make the current business models of PBMS susceptible to competition.
Is PBM Transparency a Good Thing?
December 4, 2006
PBM transparency: More than meets the eye | www.benefitnews.com
This article discusses transparency in the context of retail pharmacies; however, PBMs are most profitable in the mail order distribution channel.
Transparent PBM deals have more guarantees than implied by this article.
November 24, 2006
Pay-for-Performance Plans Now Common Among HMOs | www.nlm.nih.gov
One product the major healthplans are starting to sell are benefit plans (HMO's/PPO's) that utilize a high performance network (HPN). The HPN is a more limited network of doctors who have shown that they are providing quality service and good value from a cost standpoint.
Walmart Program Beneficial to Consumers
November 24, 2006
Wal-Mart Expands Generic Drug Program | www.newsinferno.com
Many people with health insurance have pharmacy plans with generic copays with flat dollar minimums of at least $5.
Walmart may gradually expand the program or add additional pricing tiers.
November 24, 2006
Trend: Consumers dumping HMO plans | www.fiercehealthcare.com
HMO Plans have become very similar to PPO without an out-of-network benefit.
Member cost sharing is typically lower than PPO plans making them more expensive.
September 27, 2006
When Empoyees Pay for Health Care, the Boss Pays too | online.wsj.com
CDHP's are not the "end all" to the growing healthcare problem in this country, but at least it is a beginning for the employer and employee to gain back some sort of control on the expenditure they have on insurance premiums.
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