Season 2 of the MedCity Pivot Podcast has launched with a special focus on the evolution of pharmacy and pharmacy benefit management. The first guest this season is A.J. Loiacono, who leads Capital Rx.
Kevin Sayer would love to bring his company's Dexcom G7 continuous glucose monitor to more people and more quickly. But despite being CEO of a successful device company, he feels frustrated from time to time about how and what the U.S. health system will pay for.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Javier Gonzalez, Chief Growth and Commercial Officer at Abarca, about why payers are increasingly looking for alternatives to the traditional PBM model.
Proposals targeting misaligned financial incentives, price transparency, and pharmacy access are important and necessary reforms. But the consequences of failing to address pharmacy benefit managers’ use of market power to block competition and extract monopoly profits from payers and consumers will not be limited to drug costs – it will change all of healthcare for generations.
In this month's episode, we dive into some of the recent executive appointments occurring in the healthcare sector, as well as layoffs affecting the industry. We also hear from Danny Sanchez, who recently became the new CEO of EmpiRx Health, a value-based pharmacy benefit manager.
There is a huge opportunity for PBMs and health systems to use AI to help address the challenges surrounding the affordability and accessibility of medicines, from navigating formularies to resolving prior authorization. More automation in pharmacies and with ordering workflows is one piece of that puzzle.
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
For the first time ever, CMS is preparing to negotiate prices for drugs paid for by Medicare. This has sparked a huge debate — will the creation of this taxpayer-funded drug negotiation infrastructure be a failed experiment, or will it become the standard for the future of drug pricing in this country? Jason Borschow, president and CEO of Abarca Health, says it's the latter.
Requiring that PBMs bid on a per member per month guarantee would reduce the employer’s uncertainty by securing the actual per member per month cost to the employer.
A trade association for PBMs says that state PBM regulations in Oklahoma are preempted by federal ERISA and Medicare regulations.
EmpiRx found in its data that pharmacy claims for behavioral health treatments increased 9.4% from 2020 to 2021. For antidepressants, utilization increased 12% during this time period, but per claim spend fell 1.8%. ADHD medications saw a 20.2% increase in utilization and a 9.1% decrease in per claim spend.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
The question elicited predictable and unexpected responses from panelists that included a senior executive from CVS Caremark and executives from startup companies working to change the pharmacy benefits landscape.
The MedCity INVEST Digital Health conference in Dallas September 28 in collaboration with Health Wildcatters marks our first conference in the Lone Star state and new themes embracing employee benefits and the financial experience in healthcare. Register today!
Capital Rx recently closed a $106 million Series C funding round, bringing its overall funding to $175 million. The upstart pharmacy benefit manager will use the funds to enhance its digital pharmacy platform as well as grow its user base.
The current landscape heading into 2022 will keep pharmacy benefits under the microscope. Plan sponsors will evaluate their PBM’s pricing model to determine if their contract will deliver predictable costs, more opportunities for increased savings and improved care for their members.
In a month where GoodRx’s stock has been trading below IPO levels, the startup’s leadership says Amazon Pharmacy still isn’t a threat. Citing third-party data, the company said uptake of Amazon's pharmacy services have been low, though the retailer still could pose a threat with its growing healthcare business.