Pharmacy Benefit Consultants - Drugs To Block

Recent MS Drug Developments Demonstrate Plans Should Obtain Customized Formularies ASAP

16 Feb, 2021

How Long Is Your Plan Willing To Throw Away Thousands of Dollars Per Script For An MS Drug? ____________ Review your Plan’s most expensive therapeutic categories, and it’s virtually certain you’ll find multiple sclerosis drugs among those that are ringing up the largest tab for your Plan, even though it’s estimated that less than 1 million […]

Require Your PBM To Take Action on Zytiga

10 Jan, 2019

If your Plan wants to decrease and control its costs, you need your PBM to take advantage of every Specialty Drug savings opportunity. Unfortunately, many – if not most – PBMs fail to do so. Zytiga, a high-cost treatment for metastasized prostate cancer, now has a far lower-cost generic substitute available, called abiraterone. Litigation hangs […]

Act Now – Block Lyrica CR Preemptively

17 Nov, 2017

If your Plan wants to control its prescription coverage costs – and minimize disruption to your plan beneficiaries – your Plan needs to act preemptively to block certain drugs before they even enter the market. Lyrica CR exemplifies why.

Read this to understand Pfizer’s – and other manufacturers’ – ploys that prevent your Plan from saving money from generic drugs. And learn how you can counter manufacturers’ strategies by blocking certain newly-approved, but entirely unnecessary, drugs before your Plan beneficiaries start taking them.

Plan Administrators: Limit Your Restasis Coverage

05 Oct, 2017

If you missed the latest example of drug manufacturer abuse, you need to learn about Allergan’s Restasis antics, understand your Plan’s resulting costs, and take action in response.

Why? Because you’ll not only save your Plan considerable money by acting on a single drug, you’ll also help teach Allergan a much-needed lesson and discourage other manufacturers from engaging in similar abuses.

Want To Decrease Your Rx Coverage Costs? Pay Attention to Horizon Pharma’s 1st Quarter Report

15 May, 2017

Horizon Pharma – the manufacturer of three extremely expensive drugs – Vimovo, Duexis and Pennsaid – just released its Quarterly Earnings Report causing its stock to plummet. The Report should cause every Plan to stop providing coverage for all 3 of these drugs and stop relying on its PBM’s “standard” Formulary.

Take Action To Decrease Your Plan’s Crestor Costs

17 Nov, 2016

If you examine your Heath Plan’s claims data, it’s extremely likely you’ll discover that Crestor is costing your Plan a small fortune. Typically, Crestor represents more than 1% of a Plan’s total annual drug costs. As a result, Crestor almost always appears on a Plan’s list of “Top Twenty Most Expensive Drugs.” Frequently, Crestor is among the “Top Ten” – jockeying to collect even more money from Plans than many high-cost specialty drugs.

But as if manna has fallen from heaven, there is now a means to reduce your Health Plan’s costs. Details can be found in this article.

Pay Attention to Your Metformin HCL ER Diabetes Costs

30 Oct, 2016

We regularly review our clients’ claims data to detect issues that, if corrected, can reduce our clients’ costs without harming their plan beneficiaries’ drug access. Read this short article about metformin HCL ER, and you’ll understand what we’re doing, and what every health plan can – and should – do as well.

Just How Much Is Your Plan Spending On Abilify – and Other Drugs – That Have Recently Lost – Or Will Soon Lose – Their Patent Protection ?

27 Apr, 2016

If your Plan is like most Plans in the country, you are spending a small fortune on Abilify, even though Abilify lost its patent protection in 2015 and a generic equivalent is available at far lower cost. Your Plan is also likely spending even more on Crestor, which will lose its patent protection in May 2016. And then there’s Zetia, Benicar and Seroquel XR: Each is running up significant costs for Plans, and all will likely lose patent protection before 2016 ends.

It’s time for your plan to stop squandering money on high-cost brand drugs that have lost their patents! We explain exactly what you can do to control your costs here.

Eliminate – Or At Least Decrease – Your Rx Coverage Costs For Proton Pump Inhibitors

17 Mar, 2016

Virtually all health plans are spending a large sum of money covering Proton Pump Inhibitors – drugs like Nexium, Prilosec and Prevacid, and their generic equivalents (esomeprazole, omeprazole and lansoprazole). Simply stated, health plans are wasting their money doing so.

Read this detailed article that will help you understand exactly how to eliminate – or at least significantly reduce – your Proton Pump Inhibitor costs.

Is Your Health Plan Controlling Its Testosterone Use?

24 Feb, 2016

Spend a few minutes studying your health plan’s claims data, and you’ll very likely discover your plan is spending large sums of money on men’s testosterone products.

In fact, you’ll likely discover your plan is spending several thousand dollars a year for each male beneficiary who is choosing to rub gel into his shoulders in the hope that the gel will enhance his sexuality.

But numerous previous studies – and an article in last week’s New England Journal of Medicine – make clear that covering testosterone products not only squanders your plan’s limited assets, but also subsidizes dangerous medical practices of dubious medical utility.

For an in-depth examination of the testosterone problem – and why you should take steps to address it – read this article. We’ll also provide a detailed description of precisely the steps you should take.

The Frightening Implications of Farydak & Kalydeco

13 Jun, 2015

During the first six months of 2015, the FDA approved more than a dozen new high-cost Specialty Drugs. Two of those drugs – Farydak & Kalydeco – reflect the frightening financial implications of new specialty drugs, and steps every health plan should take to control their costs.

Here’s How To Investigate – And Then Cure – Your Hep C Drug Cost Problem

24 Apr, 2015

HR Execs: You’ve undoubtedly read about PBMs’ purported hep C manufacturer “shake-down,” which PBMs claim decreased health plans’ costs for hep C drugs.

But it’s reasonably likely that your plan didn’t actually receive any benefit from PBMs’ purported shake-down. In fact, it’s reasonably clear that only the PBMs actually benefited from their secret manufacturer deals.

To understand why your hep C costs are probably as high – or even higher – than they were before PBMs’ actions, read this article. We also describe what you should do to control your hep C costs.

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