Prescription Drug Spending

BCBSAZ Tackles Medication Adherence Through Mobile Health

by Kelsey Waddill

Blue Cross Blue Shield Arizona (BCBSAZ) is using text message-based patient outreach to address prescription drug affordability and medication adherence, BCBSAZ announced. The healthcare payer has...

Employers Focus on High-Cost Claims, Drug Spending into 2020

by Kelsey Waddill

Thirty-nine percent of employers will be focusing more strategically on high-cost claims by 2020, according to a study by the National Business Group on Health (NBGH). The NBGH study drew responses...

How Health Policy is Working to Reduce Medicare Drug Spending

by Kelsey Waddill

As healthcare costs continue to escalate, policymakers have put forth numerous solutions to control Medicare drug spending and, through it, stabilize the healthcare economy, a recent Kaiser Family...

Medicare Part D Premiums Continue to Decrease, CMS Says

by Kelsey Waddill

The average basic Medicare Part D premium for prescription drug plans is projected to decline, CMS announced. “CMS has been taking action to lower the cost of prescription drugs, and we are...

Proposed Senate Act Would Restrict Pharmacy Benefit Managers

by Kelsey Waddill

The Senate Finance Committee has passed the Prescription Drug Pricing Reduction Act (PDPRA), a bipartisan piece of legislation that checks pharmacy benefit managers’ practices of overpayment and...

How Healthcare Payers Innovate Tools to Improve Price Transparency

by Kelsey Waddill

Healthcare payers are continuing to respond to industry pressure to address price transparency challenges, tapping healthcare technologies that will help them understand the true cost of patient...

White House Abandons Rebate Rule Due to Medicare Spending

by Kelsey Waddill

On Thursday, the White House backed down from its proposed rule that would have prohibited pharmacy benefit manager rebates because the rule would have raised seniors’ premiums and Medicare...

Federal Judge Strikes Down New Drug Price Transparency Rule

by Kelsey Waddill

A federal judge recently ruled in favor of a group of pharmaceutical companies challenging a new drug price transparency rule from HHS that required manufacturers to disclose wholesale acquisition cost...

CMS OKs Subscription Model in LA to Lower Hepatitis C Drug Costs

by Kelsey Waddill

CMS recently approved Louisiana’s subscription model for hepatitis C therapies in Medicaid, which would allow the state to negotiate supplemental rebate agreements from prescription drug...

Medicare Out-of-Pocket Costs Higher For Generic Drugs Vs Brand-Name

by Kelsey Waddill

A recent Health Affairs study found that some Medicare beneficiaries would pay higher out-of-pocket costs for generic drugs than for specialty or brand-name drugs. Researchers from Vanderbilt...

Driven by Prices, Medical Cost Trend Increases 6%

by Kelsey Waddill

PwC’s Health Research Institute (HRI) predicted a six percent increase in medical cost trend in 2020, with a five percent net growth rate after adjusting for increased employee cost sharing or...

CMS Approves WA Value-Based Purchasing Plan for Hepatitis C Drugs

by Kelsey Waddill

CMS recently approved Washington state’s value-based purchasing proposal to lower drug prices for Medicaid. The approval will allow the state to implement a “subscription” model for...

Prescription Drug Spending Varies by Private, Public Payers

by Sara Heath

Total prescription drug spending reached $333 billion in 2017, but the way that lump sum was divided among Medicare, Medicaid, and employer-sponsored health plans may reveal differences between the...

CMS Addresses Prescription Drug Price Spreading Issues

by Sara Heath

New guidance from CMS addresses the issue of prescription drug price spreading and reiterates Medicaid and CHIP managed care program obligations to account for the practice when calculating certain...

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