Must Read Recommendation

I typically make it 1/2-2/3 through business and/or leadership books before losing interest. I gain the insight I went into the book hoping for and move on. I can’t actually remember the last book I finished. Not this one. I couldn’t put it down. I read every last page. Therefore, I’d highly recommend it to […]

3 Combo Drugs you SHOULDN’T be Covering (but are)

3 Combo Drugs you SHOULDN’T be covering (but 77% are): LMR Plus (lidocaine patch & menthol) — Price = $4,500/monthAlternative(s): Lidocaine 4%-5% Patch = $60 + Menthol Gel = $3 Varophen (Topical diclofenac & menthol cream) — Price = $4,850/monthAlternative(s): Topical diclofenac solution 1.5% = $65 + Menthol cream = $3 *Only 23% covering this […]

Pass-Through PBM Programs

Did you know? If you are a plan sponsor utilizing a pass-through PBM program, independent community pharmacies are (in aggregate) typically your lowest-cost option? How? A few market dynamics that have created this counter-intuitive situation: -One Voice: Chain pharmacies have thousands of locations, but negotiate PBM contracts as a group. Independent pharmacies use multiple contracting […]

Overview of the Specialty CoPay “Maximization” Programs

This is the best overview I’ve found that considers all sides of the specialty copay “maximization” programs that are becoming more commonplace. Personally I’ve seen the benefits to plan sponsors and patients, but have doubts on how sustainable it will be long-term.