- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Dr Glenn Stettin Outlines the Importance of Transparency for PBMs
Being transparent is important for pharmacy benefit managers in order to know what the criteria are for coverage, said Glenn D. Stettin, MD.
Being transparent is important for pharmacy benefit managers in order to know what the criteria are for coverage, said Glenn D. Stettin, MD.
Transcript (modified)
How can pharmacy benefit managers be more transparent and how does it benefit them to do so?
I don’t know that I can speak for the industry, but I can say that at Express Scripts it is important for us, for physicians, to know what the criteria are for coverage, specifically for the plans where we manage the prior authorization process. So we make that information available that physicians can find it, and then the other areas in what drugs actually cost. One of our recent introductions is the pricing tool and mobile application for our patients, where they can actually put in the name of a drug and look it up to find what that medication would cost at the pharmacy and at different pharmacies — because sometimes different pharmacies have different pricing. Or it doesn’t help yet and we need to do more are for drugs that are billed under the medical benefit as opposed to the pharmacy benefit. And I think that we have some good plans in place to make that kind of pricing transparency available, as well.
Joanne Mizell: Lifestyle Modification Programs Take Holistic Aim at Metabolic Disease
May 1st 2024Joanne Mizell shares insurer strategies in addressing the escalating rates of metabolic diseases, highlighting the importance of holistic treatment methods like lifestyle modification programs, which integrate nutrition, physical activity, and community engagement.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
OptumRx’s Jon Mahrt Discusses “Irresponsible” Drug Pricing for Products With Multiple Indications
April 30th 2024When the same product comes to market with additional indications, irrational pricing decisions result in ever increasing prices instead of volume translating to lower costs, said Jon Mahrt, MBA, of OptumRX.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Dr Kathy Zackowski Discusses the Importance of Rehabilitation Research and Trials in MS
April 26th 2024Kathy Zackowski, PhD, National MS Society, expresses the inherent value of quality rehabilitation trials for broadening clinical understandings of multiple sclerosis (MS) and bettering patient outcomes.
Read More
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
Read More
