Smarter Decisions, Superior Outcomes

Oncology Agents of 2016: A Clinical Review

Posted by Denika Hockenhull on December 5, 2016 at 1:34 PM

Oncology management has evolved due to approval of new oncologic agents and their expensive costs. Previously, limited medication availability left practitioners with minimal options for cancer treatment. Newer cancer agents are designed to improve a patient’s quality of life and hopefully, overall outcome. With the rapid development of new oncologic medications, the management process has posed a challenge to physicians and payers. Providing oncologic medications in the most cost-effective manner requires cost-management strategies to weigh the benefits and risks.

Read More

Topics: High Cost Medications, pharmacy spend, Specialty Drug Cost Control, Specialty Drug, drug costs,, new cancer drugs, oncology medication, oncologic agents, FDA drug approvals, oncology, new oncology drugs

Balancing Effectiveness and Cost of Specialty Medications for Treating Complex Conditions

Posted by Denika Hockenhull on June 1, 2016 at 10:00 AM

Spending on specialty pharmaceuticals climbed 18 percent in 2015, compared to an increase of less than 1 percent for standard prescription medications. The burgeoning outlay comes as no surprise considering the hefty price tag of these new drugs, with some reaching upwards of $60,000 for a course of treatment.

Read More

Topics: pharmacy spend, Specialty Drug Cost Control, Specialty Drug, patient outcomes,, biosimilars, interchangables,, drug costs,, rising drug costs,

Why Health Plans Need PDMP Data

Posted by Denika Hockenhull on May 2, 2016 at 9:00 AM

It’s an inescapable truth that, in healthcare, data matters. For health information technology innovators, data is the window inside a lifecycle of a service, product, or application that can be analyzed for improvement. For providers, data helps the accuracy of diagnoses and creates more effective treatment paths. Health plans benefit from data as well. For plans, data builds actionable information and insights, two important steps in the balance of managing risk for each plan and enhancing outcomes for each member.

Health plans need access to information sources that help build for the future. But this need goes beyond simply connecting to the traditional repositories that capture and store large amounts of information. To optimize our understanding of users, patients, and members, plans must have access to sources beyond claims data. Expanded data sets from non-traditional sources will benefit plans with the right tools to manage collection and analysis.

One such non-traditional, underutilized source is prescription drug monitoring program (PDMP) data. Since the adoption PDMPs, these electronic database systems have amassed a decade’s worth of information regarding prescribing and dispensing behaviors of controlled substances as well as information that can be used to develop baselines for analysis or to monitor trends. There is an industry-wide need to make PDMP data accessible, building towards the goal of creating outcomes-based healthcare.

Building upon current frameworks of data sharing and utilization, we identify the opportunities in which PDMP data can help health plans in the future.

Read More

Topics: pharmacy spend, opioids, prescription drug monitoring, PDMP, health plan management, controlled substances

How Will the New 'Orphan Drugs' Affect Pharmacy Expenditures?

Posted by Kathleen Sabo on February 19, 2016 at 12:08 PM

In recent years, the pharmaceutical industry has experienced slowing growth on a global scale, due in part to patent expirations, increasingly tough regulations and fierce competition from generics. One sector, however, has not suffered the same fate—specialty pharmacy.

Read More

Topics: High Cost Medications, Controlling Pharmacy Expenditures, pharmacy spend, orphan drugs, Meaningful Use, Coverage Determination Process, Prior Authorization, Specialty Drug Cost Control, Specialty Drug

Independent & Objective

Clinical expertise without the noise

Getting the facts matters. Following our corporate mission, we're committed to using this blog to enhance your knowledge of evolutionary events and discussions in the pharmacy services and technology arena. 

Here's what we're focused on right now:

  • Lowering ingredient cost
  • Enhancing the coverage determination process
  • Creating robust prior authorization criteria
  • Producing actionable drug trend analyses
  • Enhancing prescription drug monitoring 
  • Implementing interoperability efforts

Subscribe to Email Updates

Recent Posts