Market Insights
The Rebate Rat Race
Previously, we looked at why rebate transparency remains so elusive. The disconnect Adam Fein highlighted in PSG's data – PBMs [...]
The Disappearing Rebate: Why “Opaque” Isn’t an Accident
In our last post, we looked at why specialty pharmacy negotiations are fundamentally conflicted: the organizations that employers rely on [...]
Your Specialty Pharmacy “Savings Strategy” Is Negotiating with Someone Who Profits Either Way
There's a question worth sitting with after reading Adam Fein's latest post on PSG's rebate data: if nearly half of [...]
Where Are the Lemon Laws for Specialty Pharmacy?
If you buy a car and it turns out to be a dud – one that spends more time at [...]
Cut and Run – United Bailing on Prior Auth.
UnitedHealth announced this week that it is scaling back prior authorization. By fall, most medical PA requirements disappear for roughly [...]
Transparent PBM Araya Announces Partnership with Ethicos Health
Araya, a transparent pharmacy benefit manager redefining how pharmacy benefits work for employers, plans, and members, today announced the launch [...]
Ethicos Health Launches to Align Specialty Drug Coverage with Clinical Effectiveness
Ethicos Health, addressing the rising cost of specialty pharmacy by tying payment to real-world outcomes, today announced its launch and [...]
Why We Built Ethicos Health: Aligning Payment with Clinical Reality
A Convergence of Crises in Healthcare Specialty pharmacy costs are breaking healthcare economics. With biologics like Humira at $8,100/month, [...]
Industry Perspective: Silly Drugs – Roflumilast Topical
As payers struggle to provide comprehensive pharmacy benefits at a reasonable cost, they must increasingly be more diligent about curating [...]
Wells Fargo Faces Health Benefits Lawsuit
Last week, four (4) Wells Fargo employees sued Wells Fargo and five (5) of its human resources leadership team for mismanagement of the prescription benefit