Employer Groups & Consultants

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How employers and TPAs can ease the rising cost of specialty drugs with medical rebates

The pharmaceutical industry is in the middle of a dynamic shift that shows no signs of slowing down. Traditional drug pipelines are now increasingly dominated by specialty drugs, many of which carry a six-figure annual per-patient cost. These drugs have become a driving force behind pharmaceutical expenditure for employer groups and present a challenge for

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Levemir Discontinuation: What You Need to Know

Novo Nordisk, a global healthcare company, has recently announced the discontinuation of Levemir, a long-acting insulin, in the United States. This significant development, announced in November 2023, is set to reshape the landscape for many relying on this medication.  Key Points of the Announcement:  Impact Period: Expected to commence in January 2024 and span through

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The Cost Implications of New Weight Loss Treatments for Plan Sponsors

See this article by AlignRx chief pharmacy officer Beckie Fenrick as it originally appeared in BenefitsPRO. With obesity rates in the United States having tripled since the 1980s, the health care system now faces an annual cost of $173 billion due to obesity-related complications, such as heart disease, hypertension, joint pain and certain types of

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Webinar on Demand: Meeting the Mandate—The TPA Path to RxDC Success

The RxDC Reporting Deadline is Approaching—Are you Prepared? At AlignRx, we provide our valued TPA partners and their employer groups with year-round pharmacy consulting and expertise. The RxDC mandate is no exception. We covered: PBM timelines—and how they impact yours Understanding PBM charges for data submission communicating them with your clients Rebates, rebates, rebates! Ensuring

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RxDC TPA Guide – What TPAs Need to Know

The RxDC Reporting Deadline Is Approaching—Are You Prepared? The Consolidated Appropriations Act has a new Rx mandate for your employer groups and the deadline is approaching—are you prepared? The new mandate requires employer-based health plans to submit information about prescription drug and healthcare spending to the Departments of Health & Human Services, Labor, and the

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Prediabetes and Type 2 Diabetes Screening

What is happening:  In August 2021 the United States Preventive Services Task Force (USPSTF) recommended that adults, aged 35 to 70 years who are overweight or obese, be screened for prediabetes or type 2 diabetes. In addition to these screenings, USPSTF recommended that clinicians should offer patients with prediabetes effective preventive interventions. Preventive interventions include

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What Employers, TPAs and Brokers Need to Know About COVID 10 Home Testing

January 10, 2022, the U.S. Department of Labor (DOL) issued guidance related to insurance coverage for COVID OTC testing, provided at no cost to covered individuals that was effective as of January 15, 2022. COVID 10 Home Testing Highlights Beginning January 15, 2022, most individuals with health insurance can purchase at home over-the-counter COVID-19 diagnostic

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