Employers

The Employee Retirement Income Security Act (ERISA) Industry Committee filed a legal challenge against the Minnesota Department of Commerce, arguing that Minnesota’s Pharmacy Benefit Manager (PBM) Licensure and Regulation Act illegally interfered with employer-sponsored health plans by restricting plan design options and increasing costs.

Payers and employers have tightened access to the glucagon-like peptide 1 receptor agonist class once these therapies became more commonly prescribed for obesity.

Employees living with diabetes often face unique challenges, such as managing blood sugar levels, balancing medication, and preventing complications, all while maintaining their professional responsibilities. This condition can lead to increased absenteeism, reduced productivity, and rising health care costs.

As health care costs escalate, a new survey reveals that 74% of employers are grappling with the impact on employee wages and benefits, with many anticipating further cost-shifting to their workforce.

The US should consider reducing or eliminating employer-sponsored insurance. Here are some ways to do it efficiently.

The findings may help inform policy changes at the federal level aiming to address unfair and deceptive pharmacy benefit manager (PBM) practices.

This article first appeared on The Center for Biosimilars®.

This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.

Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.

Representatives from ICON plc and Symphony Health joined forces at AXS24 to discuss the challenges of managing high-cost specialty drugs and how they influence self-funded employer benefit plan design and employee access to specialty medications.

After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.

Friday's keynote speaker, Katherine A. Meese, PhD, addressed the conference theme of workforce support at the Association of Cancer Care Centers 50th Annual Meeting and Cancer Center Business Summit.

Patients enrolled in a preventive drug list (PDL) benefit saw an 8.4% reduction in acute, preventable diabetes complication days, and PDL members residing in lower-income areas saw a 10.2% decrease compared with control members.

Drug prices in the US increased 4.4% annually and median out-of-pocket (OOP) costs increased 9.6% annually from 2009 to 2018, but there was no direct link between these amounts for individual drugs.

Insomnia, along with other sleep disorders, were found to negatively impact workplace productivity.

A direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.

At the 2023 Greater Philadelphia Business Coalition on Health annual conference, a panel of employers shared their advice on incorporating the principles of value into health benefits.

At the 2023 Greater Philadelphia Business Coalition on Health, panelists described the ways their organizations are promoting access to primary care in hopes that it can be part of the progress toward achieving the Quadruple Aim of lower costs, better outcomes, patient satisfaction, and clinician experience.

Kicking off the 2023 Greater Philadelphia Business Coalition on Health annual conference, Mark Fendrick, MD, of the University of Michigan, delivered a keynote exhorting the audience of employers and payers to implement the principles of value-based insurance design (VBID) in order to improve individual and population health and drive toward equity.

Coverage from the Greater Philadelphia Business Coalition on Health (GPBCH) daylong Oncology Management Summit, held April 4, 2023.

The Employer Playbook on Biosimilars highlights strategies employers can use to navigate challenges around ensuring employee access to biosimilars at the pharmacy, as well as how to respond to pharmacy benefit managers who aren’t making biosimilars available on the formulary, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Equity has to be made front and center in conversations about value assessment, otherwise all stakeholders will continue waiting for someone else to make the first move, said one panelist at the Value-Based Insurance Design Summit.

Insured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.

For employers, keeping members engaged with their health care is one of the key factors that leads to better outcomes, said Jeremy Wigginton, MD, vice president of health quality and innovation at Blue Cross and Blue Shield of Louisiana.

A new resource from the National Alliance of Healthcare Purchaser Coalitions aims to help plan sponsors adopt biosimilars into their pharmacy benefit plans.

Virtual care not only means saved time and costs for employees, but improvements to employers' bottom lines, through more proactive management of health concerns, notes UCM Digital Health CEO and co-founder Keith Algozzine.

The first of at least 8 adalimumab biosimilars has finally launched in the United States after being kept off the market for years due to settlement agreements with the maker of the reference product, Humira.