Pharmacy Benefit Management

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 […]

Levemir Discontinuation: What You Need to Know Read More »

Medicaid AMP Cap Removal: Market Changes & Rx Strategies Amidst New Provisions

The ever-evolving pharmaceutical landscape is no stranger to reforms and regulations. With the recent changes brought about by the American Rescue Plan (ARP) of 2021, both Pharmacy Benefit Managers (PBMs) and Drug Manufacturers are adjusting their strategies. This article dives deep into these shifts and the subsequent reactions from industry stakeholders.   Market Events and their

Medicaid AMP Cap Removal: Market Changes & Rx Strategies Amidst New Provisions Read More »

Why Carve-Outs Happen And How To Prevent Them

See this article by AlignRx CEO Kevin Kobielski as it originally ran in Healthcare Business Today.  Carve-outs can be a thorn in the side of health plans. But with a little creative thinking in key areas, insurers can solve the problems that cause employer groups to rely on carve-outs.  For employers, the appeal of carve-outs

Why Carve-Outs Happen And How To Prevent Them Read More »

How Specialty Drug ‘Solution Stacking’ Can Rein in Pharmacy Benefit Costs

Brokers and employer groups alike know that 5% to 10% percent of insured workers and their dependents drive 50% to 60% of the cost of pharmacy claims. A few members with prescriptions for a specialty drug with a five-figure price tag can easily represent the majority of an entire group’s pharmacy spend. These drugs are

How Specialty Drug ‘Solution Stacking’ Can Rein in Pharmacy Benefit Costs Read More »