PBM Consulting – Top 15 Therapeutic Classes

July 26th, 2010

IMS Health data for 2009 creates an interesting picture of global drug sales and growth in specific therapeutic classes. WBC (wbcbaltimore.com) has taken a look and found that the global picture is clearly different when compared to U.S. pharmacy benefit plan sponsor drug spend. In the U.S., antipsychotics were the leading therapeutic class with $14.6 billion in sales. Antilipididemics (like Lipitor, Crestor, simvastatin, etc.) with $14.3 billion is number two; acid reflux (Nexium, Prevacid, etc.) with $13.6 billion in sales comes in at number three; and antidepressants (Cymbalta, Effexor, etc.) holds down the number four spot with $9.9 billion in sales. Surprisingly, oncology agents, while number one globally in sales, ranks number six in the U.S.

Here are the global sales and growth numbers for 2009:

Drug Class	2009 Sales (billions)	Annual Growth
Oncologics	$52.37	8.8%
Lipid Regulators	$35.28	4.9%
Respiratory Agents	$33.59	11.0%
Antidiabetics	$30.40	13.4%
Anti-ulcerants	$29.61	0.6%
Angiotensin II Antagonists	$25.20	11.4%
Antipsychotics	$23.24	4.6%
Antidepressants	$19.41	-1.3%
Autoimmune Agents	$17.96	18.0%
Platelet Aggr. Inhibitors	$14.60	9.0%
HIV Antivirals	$13.75	14.9%
Anti-epileptics	$12.99	-19.8%
Narcotic analgesics	$11.23	8.6%
Non-narcotic analgesics	$11.17	7.3%
Erthropoietins	$10.80	-4.1%

Data source: IMS Health

Share:

Tags: drug cost reduction, Global drug spending, PBM Consulting, Prescription Drug Benefits, Prescription Drug Cost Reduction, Prescription Overutilization, Prescrition Drug Costs, Reducing Prescription Drug Costs, U.S. drug spending
Posted in Most Popular Posts | No Comments »

PBM Consulting – Financial Incentives

July 13th, 2010

Decisions decisions! Benefit managers and prescription benefit plan sponsors face the challenging balancing act of getting more members to take their medications while controlling their health plan costs. The logic appears intuitive: the more members stay compliant with their drug regimens, the fewer emergency room visits and in-patient hospitalizations. Studies have shown that 25% of prescriptions go unfilled and almost 50% of patients don’t take their medications as prescribed. The problems are that (1) more drug compliance means more up-front costs via increased drug spend; and (2) trying to determine what types of incentives or penalties need to be used in order to motivate members to take their medication is a work in progress.

At WBC (wbcbaltimore.com), we have found that the most popular technique being currently utilized is benefit design, the so called “value-based” benefit design. This is where co-payments are reduced or waived for those proven medications that help regulate health status for chronic conditions such as diabetes and asthma. But is that enough? Some plan sponsors don’t think so. They are trying a new incentive: a compliance lottery! Here’s how it works: certain drugs are identified as being lottery-eligible. A special dispensing mechanism records which patients are taking their drugs and gives them the chance of winning a lottery prize ranging from $10 to $100 each day they are compliant. Aetna is one of the first health plans that is exploring this approach with some pilot programs.

Will it work? We don’t know, but we have our doubts. People do love lotteries, but research has shown that the penalty approach, i.e., the fear of loss, trumps the anticipation of gain as a motivational force. Maybe a better approach is to create a fear of not winning the lottery! Plus, the current monitoring systems might be gamed. They can monitor dispensing, but it doesn’t neccessarily mean the patient is taking the medication.

We’ll be watching the results to see if paying members to take their meds proves to be a viable option in our ongoing efforts to improve health status and quality of life while managing costs.

Share:

Tags: drug cost reduction, financial incentives, PBM Consulting, Pharmacy Benefit Cost Reduction, Prescription Drug Benefits, Reducing Pharmacy Benefit Costs, Reducing Prescription Drug Costs, value based benefit design
Posted in Most Popular Posts | No Comments »

PBM Consulting – Access Based Network Design

June 29th, 2010

Never let it be said that Walmart doesn’t know marketing. In the aftermath of the CVS/Caremark/Walgreens turf battle, where the question of adequate member access was raised (Networked), Walmart jumps right back into the frey and releases their low-price network option. They are referring to it as *Access Based Network Design* and are touting it as a new strategy to “create a break in the cost curve and slows future cost increases by applying downward pressure on cost. How, one might ask? At WBC (www.wbcbaltimore.com), we know the answer. It’s by finding the right-sized network to fit the access needs of the payor.

Walmart bases this strategy on three tenets of pharmacy cost containment:

Leverage supply and demand to create competition among pharmacy providers;
Build the right-sized network from the “bottom-up” determining the number of pharmacies the payor’s population needs rather than the number of pharmacies out there; and
Offer financial incentives to plan members to influence steerage and offset any disruption or inconvenience.

Sounds promising so far. I mean, is there really any reason to offer a 60,000+ store network? In some markets, there is literally a network pharmacy on every corner. Most plan sponsors can get along just fine with a much smaller offering, something in the 20,000 store range. Walmart makes the case that, rather than having incentives to keep prices as high as possible without getting kicked out of the network, the Access Based Network aligns the pharmacy’s interest with the payors, competing to be included by reducing their prices.

Building a right-sized network may be easier than the plan sponsor has been led to believe and without major disruption to their members. Medicare, for example, has established an access standard that can prove very instructive for a commercial plan sponsor. The Medicare standard is:

Urban Access- On average, at least 90 % of Medicare beneficiaries who live in an urban area must have access to a network pharmacy within 2 miles of their home.

Suburban Access – On average, at least 90% of Medicare beneficiaries who live in a suburban area must have access to a network pharmacy within 5 miles of their home.

Rural Access- At least 70% of Medicare beneficiaries must have access to a network pharmacy within 15 miles of their home.

As mentioned above, this standard can almost always be met with 20,000 or less pharmacies!

The financial incentives to members can be the final piece that puts this type of strategic plan design in play. A reduced co-pay to offset any inconvenience of driving a few more blocks could do the trick. Many times, it does not have to be a huge enhancement. Walmart suggests that a $10 co-pay could be reduced to $7, for example.

WBC has been a big proponent of right-sized networks for some time and this organized effort by Walmart is an aggressive step in the right direction. That being said, Walmart does not hold an exclusive with this type of concept. Keep in mind they are not trying to become a PBM. They promote their efforts as PBM-agnostic. Just about any PBM worth their salt can design and manage a selective network of this type. We think you’ll find it’s worth discussing with your PBM.

Share:

Tags: Access Based Network Design, drug cost reduction, PBM Consulting, Pharmacy Benefit Cost Reduction, Prescription Drug Benefits, Prescription Drug Cost Reduction, Reducing Pharmacy Benefit Costs, Restricted Networks, Restricted Pharmacy Network, Right Sized Networks
Posted in Most Popular Posts | No Comments »

PBM Consulting – War of the Worlds

June 11th, 2010

Round Two (or is that Round Three) of the CVS vs. Walgreens knockdown has gotten folks attention. Walgreens came out swinging, both fighters felt each other out, and CVS counter punched with the announcement that, rather than wait for contract renewals to have Walgreens leave the Caremark network, they will take a proactive stance and end the network participation in 30 days. (http://bit.ly/bTUZfU)

For the original story, See *PBM Consulting – Networked?* at http://www.wbcbaltimore.com/blog/

This frontpage slugging back and forth between these two heavyweights has also captured the attention of Congress. The PBM industry has long avoided federal scrutiny and oversight. Their business practices and market conduct are juicy targets for a Congress and an Administration hungry for power and control. No crisis (real or contrived) is going to go unnoticed these days. Reps. Bruce Braley, D-Iowa, and Peter Welch, D-Vermont, have started the inquiry by sending a letter to three powerful House committee and subcommittee chairmen, calling for enhanced congressional oversight of the PBM industry and requesting a hearing on current industry practices!

Seems like Congress may just be waking up to what approximately 30 State Attorneys General have already started, that is, an attempt to bring some real transparency to the PBM world. Many pharmacy benefit plan sponsors have wondered why “traditional” PBM business practices have continued under the radar for so long. After all, Third-Party Administrators (“TPAs”) who are paid to process medical claims on behalf of health plan sponsors, would be shuttered and their officers indicted if they ran their businesses in a fashion similar to many PBMs!

Here’s a link for more details of Congressional interest: http://bit.ly/9iFGOl

WBC will continue to follow these developments to keep you informed regarding PBM news that may effect the operation of your plan. Visit us at www.wbcbaltimore.com

Share:

Tags: Congress regulates PBMs, drug cost reduction, PBM Consulting, Prescription Drug Benefits, Walgreens leaves Caremark network
Posted in Most Popular Posts | No Comments »

PBM Consulting – Networked?

June 8th, 2010

To quote the great Peter Finch’s character Howard Beale in Network ”….My life has value….I’m mad as hell, and I’m not going to take this anymore.” I guess this may apply to anticipated potential unrest when pharmacy benefit plan sponsors go to renew their CVS/Caremark contracts and find out that Walgreens has decided to drop out of the Caremark network. While it won’t take effect for current contracts, it will apply for all new contracts and renewals. With the announcement yesterday (http://bit.ly/cUXu80), Walgreens sent the analysts scurrying for answers. Was this a pre-emptive strike against an arch-rival, a response to the market impact that Caremark’s Maintenance Choice (90-Day at Retail program) has had, or a little of both? Maybe even a little competitive envy, since Walgreens PBM arm, Walgreens Health Initiatives, offers a similar 90-Day at Retail program to Caremark’s, called Advantage 90. In any case, it was a bold announcement by Walgreens, since the Caremark business represents about 11% of their revenues!

In our opinion, this movement is the beginning of what we’ll call “Being Networked.” It’s actually a progression of what we at WBC (www.wbcbaltimore.com) , and others have called “The Walmart Effect,” i.e., bringing improved pricing through select networks (we like that term over “restricted”). Being Networked then means that plan sponsors will be presented the choice of reducing the size of their PBM network in exchange for improved pricing, all while trying to balance any potential employee/member noise over the loss of retail outlets. In the case of Walgreens and Caremark, however, the plan sponsor won’t have a choice. Walgreens has made it for them!

A number of issues remain to be seen. Will Caremark find 1/1/11 renewals difficult to sell, without the Walgreens stores? Will employees/members really care? Will improved discounts off of AWP (as a result of a select network)really change the net cost of drugs to any substantial degree? As in most areas of PBM-ology, the answer is ” It depends.” Mostly, it depends on the geography of the plan sponsor and their employees/members. In many areas, Caremark can easily jettison Walgreens without missing a beat. Benefit managers will hardly hear a peep from employees, simply because CVS, Rite-Aid, Walmart, Target and the supermarkets offer more than adequate access. The fact is, just about no plan sponsors needs the full 60,000+ store retail networks offered by most PBMs. The opposite is also true in some markets where Walgreens rule. It should be interesting to see what happens in metro NYC with the Duane Reade chain that was purchased by Walgreens in March 2010 and remains the dominant retail outlet in that market .

The real story behind the story, however, in the opinion of WBC, is how does a plan sponsor select a PBM to manage their pharmacy benefit? The plan sponsors generally are looking for three things: reduced cost, member satisfaction, and management assistance so the H.R. departments aren’t taxed with pharmacy benefit- related issues. This announcement from Walgreens may motivate plan sponsors to dig a little deeper as to what they are receiving from their PBM. We believe it should also open the discussion regarding not just meaningless superficial discounts in a spreadsheet analysis, but real plan management for significant reduced net cost.

Share:

Tags: CVS/Caremark, drug cost reduction, PBM Consulting, PBM Direct Contracting, Prescrition Drug Costs, Reducing Pharmacy Benefit Costs, Walgreens
Posted in Most Popular Posts | No Comments »

PBM Contracting – Big MAC is a Whopper

June 2nd, 2010

PBM pricing is still a mystery to most plan sponsors of pharmacy benefits. At WBC (www.wbcbaltimore.com), we’re continually seeing spreadsheet comparisons of one PBM’s versus another. Is that AWP-58% or AWP-62%? Which one is better? Which one represents lower cost of the plan sponsor? On the surface, a reasonable person might surmise that -62% is a deeper discount than -58%, thereby yielding a lower net cost. Ah, but not so fast!

The answer to which is better. i.e., which costs less is “It depends.” It depends on what the AWP price is that’s being reduced by the discount. This is particularly true when trying to compare costs of generics. There may be 5 or 6 or more manufacturers of the generic drug that could be filled at the pharmacy, either at retail or mail. Here’s an example: Fluoxetine (generic Prozac) has an AWP of between $0.72 and $3.55 per pill when compared between five manufacturers of the generic. Obviously, taking 60% off of the $3.55 option yields a higher payment from the plan sponsor than a 58% discount off a $0.72 pill. One answer to this dilemma is the creation and application of a MAC list.

MAC is the acronym for Maximum Allowable Cost (“MAC”) and serves as a reference price to establish a maximum cost that the PBM will pay for a generic drug. Each PBM applies a “secret sauce” that they usually view as a proprietary methodology to come up with their MAC list and pricing, but for simple illustrative purposes, think of it as an arithmetic mean to reach a price (i.e., five manufacturers with pricing ranging from $.72 to $3.55, add up the individual prices and divide by 5). In the example of the Fluoxetine, the MAC price may be $2.22. This will be the maximum cost that a PBM would pay to the pharmacy.

Simple enough, and pretty straight forward if this is where the story ends. Again, not so fast! Many PBMs confuse the solution by creating multiple MAC lists. Each one may represent different pricing and a different number of drugs. Some lists may only include a relatively small number of drugs (300 for example), while others can be very broad (over 2,000 drugs). It serves the interest of the plan sponsor to receive the broadest possible MAC, since the MAC pricing represents the largest equivalent AWP discounts (some MAC pricing is equal to AWP-95% or more). When a generic drug is not on the MAC list, it will receive a much lower discount and may be as low as the brand discounts (AWP-18% for example). Some PBMs have what are known as the “Bill MAC” and the “Pay MAC.” This may come as a shocker to the plan sponsor, but a PBM may submit one Bill MAC to the plan for payment and turn around and use a Pay MAC to the pharmacy, which has entirely different and higher pricing. The PBM pays a lower price to the pharmacy, but bills the client and inflated cost, creating a pricing spread that makes the PBM’s shareholders very happy.

Another Big Mac attack is when the PBM only applies MAC pricing at retail, leaving mail order generics as their holy grail for PBM profit potential. For PBMs that provide a true pass-through pricing model, it doesn’t matter, because you will receive whatever the discount turns out to be. Under traditional pricing, however, MAC pricing at mail will reduce the plan sponsors cost through that channel. The PBMs typically don’t volunteer to offer MAC at mail. The plan sponsor has to request or negotiate it as a feature in their PBM contract.

What’s the take-away to this story? First, decide if undisclosed pricing spreads are acceptable to your view of vendor relationships; second, make sure your PBM offers you a broad MAC list; and third, if you use a PBM that has your plan on a traditional pricing model, require that MAC pricing be applied at mail.

Share:

Tags: drug cost reduction, MAC pricing, PBM contracting, Pharmacy Benefit Cost Reduction
Posted in Most Popular Posts | No Comments »

Pharmacy Benefit and Healthcare Reform – “It’s Alive”

March 6th, 2010

“Officials announced today that passing the Senate’s version of healthcare reform will end heart disease, cure cancer and increase every family of four’s net worth by $1 million dollars over the next ten years.” And so it seems as one unbelievable claim after another is trumpeted as justification to launch this monstrous piece of legislation onto the American public. And like the Frankenstein Monster (huge, ugly, but really just misunderstood) this healthcare ”thing” will be very difficult to kill once it has been given life.

Loyal readers may be wondering how pharmacy benefits will be impacted by this tale from the crypt (wait, is that Frankie or Harry Reid?). Here’s how:

Pharmacies will begin to restrict access by refusing to accept Medicaid payments. Walgreen’s announced today that they will no longer be accepting new Medicaid patients in Washington state after April 16th. 2011367936_walgreens18m.html Expect others to jump on board, both in other jurisdictions as well as other chains. With millions of newly eligible Medicaid beneficiaries, this will prove problematic, not just for getting scripts filled, but as a barometer of access problems in the physician provider community as well.

Employer plan sponsors will also begin to drop coverage as soon as they find out that the cost of continuing their programs far exceeds the penalty they will have to pay by opting out. Medical benefits as well as Rx plans, will be transferred to the The Insurance Exchanges that will be established to offer subsidized individual coverage for non-corporate plan participants, and who will ultimately drive private insurers from the arena.

What remains to be seen are the issues related to formalizing a program of pharmaceutical re-importation, allowing the Secretary of Health and Human Services the ability to negotiate prescription drug prices with pharmaceutical companies, or authorizing a regulatory pathway that will lead to FDA approval of generic biologicals.

What’s known is we will wind up with far less competition, reduced access, higher costs and a staggering, unsustainable new unfunded entitlement program!

Share:

Tags: Healthcare Reform, Prescription Drug Benefits, Prescription Drug Costs, Reducing Healthcare Costs
Posted in Most Popular Posts | No Comments »

PBM Consulting -Trends in Pharmacy Benefit Management

February 25th, 2010

Plan sponsors are requiring more from their PBMs…. more service, more transparency, more cost reduction. What are the industry trends that will influence the PBM industry’s ability and willingness to deliver? WBC, along with our subsidiary PharmaSeer, gazes into our crystal ball to predict what you can expect….

Top 10 Trends for 2010/2011 and Beyond:

1. Value-Based Plan Design. For all Wellness and Population Health Management programs, compliance is the name of the game. Helping members stay compliant with drug therapies through the removal of potential barriers is how it’s done. Benefit designs that reduce or eliminate co-pays that may serve as a financial deterrent, as well as creative home delivery incentives and maintenance-at-retail options will prevail. Also, 4th and 5th tier plan designs will become commonplace.

2. Generic Utilization. Still the big enchilada of Rx cost-containment strategies. Profitable for the PBM, lowers cost to the plan sponsor and member. What’s not to like? Keep in mind that a plan sponsor needs to check to make sure that the PBMs efforts to drive home delivery generics do not create a higher net cost to the sponsor when compared to retail for certain drugs. Requiring the broadest MAC list, without allowing the PBM to switch lists at its discretion, and having it apply at both retail and mail is the way to slay.

3. Right-Sized Networks. A WBC-term that sounds so much better than “restricted.” Do we really need 57,000+ stores to meet the needs of our members? In a word, no. Most groups will do just fine with a 30,000 store option and many can work with only 18,000 stores in the network. Plan sponsors can reduce their cost through better discounts and reduced net cost pricing by creating steerage to a directed network using a Walmart or Walgreen’s, as examples.

4. Restricted Formularies. Let’s call it “select formularies.” These are closed formularies that have been crafted based on a true net cost objective and evidence-based value, not for the purpose of generating rebates.

5. New Pricing Methodologies. The bell tolls for AWP! Let’s not lose the opportunity to create more transparent pricing as we move toward actual acquisition cost basis. In the interim, we’ll see more AMP or WAC alternatives. This extends to pricing requirements for an all-inclusive generics option, so that the gaming of adjudicating at brand or non-MAC discounts is eliminated. Specialty will move toward ASP pricing.

6. Specialty Integration. Specialty continues to grow as a significant piece of the drug spend. Too often, a PBM account manager can’t answer client questions regarding specialty utilization due to lack of communication between operating groups. Cost savings can only occur through better unit cost discounts and therapy management. A recent study indicated that only 50% of self-funded employers have adopted a specialty drug strategy.

7. Personalized Medicine. Genetic testing to determine which medication therapies have the best chance at improving a patient’s health status or controlling their disease state. Several PBMs are investing heavily is this arena.

8. Comparative Effectiveness Research. Does a new drug really work better or does it just cost a whole lot more? This is the question to which plan sponsors will demand an answer. Evaluating NNT (“Numbers Needed to Treat”) will make a resurgence amongst epidemiologists and will be introduced to employer plan sponsors.

9. “Follow-On” Biologics. Generic versions of expensive specialty drugs, sometimes referred to as “Biosimilars” or “Follow-On” Biologics, will push forward, at least as long as Rep. Henry Waxman stays in office. The EU has approved 10 biosimilars for use in Europe. The FDA will need to sign-off on a pathway for the approval process in the U.S. Waxman’s H.R. 1427 will be resurrected this year.

10. Drug Importation. Another political football that seems to have public support. A trade-off of pharma’s endorsement for healthcare reform was for Washington to kibosh the importation initiative. We don’t expect it this year, but bet it will come to pass prior to 2012 election

Share:

Tags: Change in AWP, PBM Consulting, Prescription Drug Cost Reduction, Reducing Health Care Costs, Reducing Prescription Drug Costs
Posted in Most Popular Posts | No Comments »

The Okra Effect – Reducing Pharmacy Benefit Costs

February 8th, 2010

Diabetes as a consequence of American lifestyles continues to rage in epidemic proportions. According to statistics from the American Diabetes Association (www.diabetes.org), 23.8 million people have diabetes (10.7% of the population over Age 20 and an additional 57 million people who are in a pre-diabetes stage). If current trends continue, 1 out of 3 children born in the year 2000 will develop diabetes by 2050! Throw in the complications of diabetes including heart disease, kidney disease, high blood pressure, nervous system disease, stroke and blindness and the total healthcare costs are staggering.

This healthcare crisis has not gone unnoticed by some influential folks. Of course, one of the biggest names temp in “cause awareness” is Oprah. It was recently announced that she is helping raise diabetes awareness by promoting free blood glucose screenings at Walgreen’s (Free-Blood-Glucose-Screening-at-Walgreens).

Hopefully people will hear the message and respond. Many in the media refer to it as “The Oprah Effect” and the need is huge. There are 5.7 million that have diabetes and have not yet been diagnosed.

While this is a great effort and getting folks in to be tested will save lives, it may not have much of an immediate effect on reducing pharmacy benefit costs. In fact, short-term costs will escalate while potentially reducing the overall costs of healthcare over a more mid-term period.

In addition to screening, we would like to see Americans get serious about their dietary and exercise habits in order to turn the tide on this deadly trend. We’re thinking of it as “The Okra Effect”, Okra one which incorporates fresh fruits and vegetables as a bigger component of our menu. The fact is that okra (as just one example) is great for you, and that the mucilage and fiber in okra helps adjust blood sugar by regulating its absorption in the small intestine.

So this should be an easy recipe: more fruits and vegetables; mix in a heaping portion of moderate exercise (like walking); yields better glucose control with reduced dependency on manufactured pharmaceutical products; and equals less pharmacy benefit spend!

Share:

Tags: Pharmacy Benefit Cost Reduction, Prescription Drug Benefits, Prescription Drug Cost Reduction, Prescription Drug Costs, Reducing Prescription Drug Costs
Posted in Most Popular Posts | No Comments »

PBM Consulting – Restricted Networks

January 18th, 2010

2010 is in full-swing and PBM trends for the year are beginning to take shape. One trend that will gain momentum this year is the use of restricted pharmacy networks.

Restricted Networks At one time, the larger networks were considered a competitive advantage, providing maximum convenience to enrolled populations. The realtiy is that very few plans need the “convenience” of 57,000+ participating pharmacies. In some metropolitan areas, there are literally pharmacy options on every corner. Most plans can meet the needs of their employee/members with a 15,000-18,000 store network, and in some cases, substantially less. The benefit of losing this excess baggage are better discounts and lower net pricing.

It has been interesting to listen to the dialogue that has evolved between finance and human resources within organizations that are considering more aggressive cost-reduction proposals for controlling their benefit costs. We have heard from several CFOs who were willing to disregard any anticipated employee disruption as a result of making this move.

Walmart and Walgreen’s are two chains that are being very aggressive in their promotion of creating a more “exclusive” retail alternative. Plan sponsors can achieve better net cost by steering employee/members to the stores of choice. The Caterpillar experience and the associated publicity will provide ground-breaking evidence (or not) that this strategy is one to be emulated by other sponsors.

Another alternative to consider for those sponsors who want to maximize their prescription drug cost savings while providing employees with more-than-ample choices for script fulfillment is to contract with a PBM that embraces full pass-through or acquisition cost pricing. This business model utilizes an administrative fee as the primary or, in some cases, the only revenue source to the PBM. All discounts, rebates and purchasing incentives are passed-through to the plan sponsor without the creation of pricing spreads, thereby reducing the size of the invoice that gets presented to the plan sponsor for payment.

All-in-all, the aftermath of AWP pricing adjustments has created an environment where plan sponsors are questioning the discounting methodology typically deployed and are searching for better value. Restricted networks may be a useful alternative.

Share:

Tags: "Reducing Prescription Drug, Costs", PBM Consulting, PBM Direct Contracting, Prescription Drug Cost Reduction, Reducing Pharmacy Benefit Costs
Posted in Most Popular Posts | No Comments »

PBM Consulting – Top 15 Therapeutic Classes

PBM Consulting – Financial Incentives

PBM Consulting – Access Based Network Design

PBM Consulting – War of the Worlds

PBM Consulting – Networked?

PBM Contracting – Big MAC is a Whopper

Pharmacy Benefit and Healthcare Reform – “It’s Alive”

PBM Consulting -Trends in Pharmacy Benefit Management

The Okra Effect – Reducing Pharmacy Benefit Costs

PBM Consulting – Restricted Networks

Recent Posts

Archives

July 2010
M	T	W	T	F	S	S
« Jun
			1	2	3	4
5	6	7	8	9	10	11
12	13	14	15	16	17	18
19	20	21	22	23	24	25
26	27	28	29	30	31