by Team PCM | Jan 6, 2023 | Blog Post, Pharmacy Benefits
Switching from an expensive brand-name medication to a lower-cost generic alternative is a proven savings strategy self-insured plan sponsors employ to reduce plan and participant costs. However, plans may miss significant savings by focusing only on brand-to-generic...
by Team PCM | Oct 24, 2022 | Blog Post, Pharmacy Benefits
The passage of the Inflation Reduction Act (IRA) in August 2022 will impact patients, providers, and benefit plan sponsors by disrupting drug pricing. The IRA allows the Department of Health and Human Services to negotiate specific drug prices for the Medicare...
by Team PCM | Sep 14, 2022 | Blog Post, Pharmacy Benefits
Biosimilar drugs are “highly similar to” and have “no clinically meaningful differences” from existing FDA-approved biologics. Currently, there are 38 biosimilars on the market, giving patients safe, cost-effective alternatives to high-cost biologics. Adoption of...
by Team PCM | Jul 21, 2022 | Blog Post, Pharmacy Benefits
One in ten people in the United States has diabetes. $1 in $4 of US healthcare costs is spent caring for people with diabetes, resulting in a 26% increase in the cost of diagnosed diabetes from $245 billion in 2012 to $327 billion in 2017. Hospital inpatient care, the...
by Team PCM | Jun 28, 2022 | Blog Post, Medical Benefits
Pharmacy costs get all the press for rising prices; however, brokers and plan sponsors need to consider medical pharmacy if they want a complete picture of plan spend. Medical pharmacy is the management of drugs billed under the medical benefit. Most often, these...
by Team PCM | May 24, 2022 | Blog Post, Contract Management
When evaluating a PBM contract at renewal or mid-term market check, brokers and plan sponsors should be asking questions. Questions that lead to a thorough understanding of their current PBM contract so they can negotiate better, plan-centric programs. Beyond basic...
