Rx Alerts

Act Now – Block Lyrica CR Preemptively

17 Nov, 2017 0.

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

Plan Administrators: Limit Your Restasis Coverage

05 Oct, 2017 0.

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

Plan Administrators and Fiduciaries: It’s Time To Take REBATE ACTION – File An Accounting Procedure!

10 Jul, 2017 0.

PBMs' questionable rebate conduct, every Plan administrator and fiduciary should consider filing a lawsuit against your PBM seeking an "accounting". As a Plan administrator or fiduciary, you're charged with ensuring

Express Scripts’ Lawsuit Reveals Striking Information About PBM Rebates

31 May, 2017 0.

For years, every PBM has refused to disclose the "rebates" that it earns on a drug-by-drug basis. As a result, no one has been able to detect the "net cost"

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

15 May, 2017 0.

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

Striking Savings Are Possible (But Your Plan Needs To Act To Obtain Them)

30 Apr, 2017 0.

We're thrilled to report that yet another Coalition Member that followed our Coalition's recommendations and took aggressive steps to control its prescription coverage costs has now achieved a 16% cost

Pull Back the Curtain on Manufacturers’ and Switch Operators’ Efforts To Undermine Your Plan’s Cost Savings Efforts

11 Jan, 2017 0.

Plan Administrators: Have you ever heard of "switch operators"? Do you have any idea what they do? Most important, do you realize that drug manufacturers are surreptitiously paying switch operators

Don’t Be Fooled By Eli Lilly’s & Express Scripts’ New Diabetes Program

21 Dec, 2016 0.

If you've been preoccupied with Trump's latest cabinet appointments, you may have missed the news about a new program sponsored by Eli Lilly and Express Scripts. With great fanfare, the

Don’t Be Duped By Manufacturers’ Single Digit Price Increase Pledges

21 Dec, 2016 0.

Recently, Novo Nordisk's President became the second drug manufacturer to make a "Single Digit Price Increase Pledge." Replicating Allergan's vow three months ago, Novo's Jakob Riis promised that Novo would

Message from Mylan: Pay Attention to Rebates

17 Nov, 2016 0.

For more than a decade, our firm has called on every PBM to identify all rebates (and other monies) the PBM is receiving from manufacturers - as well as the

Take Action To Decrease Your Plan’s Crestor Costs

17 Nov, 2016 0.

  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

Pay Attention to Your Metformin HCL ER Diabetes Costs

30 Oct, 2016 0.

If you examine your claims data, you'll likely discover that among your "Top 50 Most Expensive Drugs" is a line item for generic "metformin HCL ER". Metformin HCL is a

Additional Information About New Drugs’ Dangers

09 Oct, 2016 0.

We previously wrote about new drugs' dangers, and received many requests for additional information. Accordingly, we thought our readers would benefit from the following additional information reflecting why all health

Protect Your Plan Beneficiaries From New Drugs’ Dangers

06 Oct, 2016 0.

The latest FDA Black Box Warning about hepatitis C treatments demonstrates why it's imperative that your Plan implement methods for protecting your beneficiaries against the dangers of new drugs. After

Does Your Health Plan Actually Need the Large Chain Pharmacies In Your Retail Pharmacy Network? (The Short Answer is “No!”)

25 Sep, 2016 0.

Most health plans' prescription coverage programs allow plan beneficiaries to purchase drugs at virtually all retail pharmacies in the United States, regardless of the prices charged by those pharmacies. But

Are You Taking Action To Protect Your Health Plan Against Extreme Drug Price Increases?  

22 Jun, 2016 0.

You've undoubtedly heard that Turing Pharmaceuticals purchased a low-cost drug, Daraprim, and raised its cost by 5433% last year. And Turing's smug CEO, Martin Shkreli, defended the price hike as

It’s Time To Stop Paying For Drugs That Were Never Even Approved By The FDA 

26 May, 2016 0.

Approximately 100 years ago, at the turn of the twentieth century, anyone could market any concoction claiming it solved any - or every - health problem. Dr. Bull advertised a

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 0.

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

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

17 Mar, 2016 0.

Virtually all health plans are spending a small fortune covering Proton Pump Inhibitors - drugs like Nexium, Prilosec and Prevacid, and their generic equivalents (esomeprazole, omeprazole and lansoprazole). Unfortunately, almost

Is Your Health Plan Controlling Its Testosterone Use?

24 Feb, 2016 0.

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

Are You Protecting Your Health Plan Against Astronomical Drug Price Increases?

27 Sep, 2015 0.

Drug prices were in the news this week because of a shocking 5000% increase in the cost of a single drug: Daraprim. But during the first 9 months of 2015,

The Frightening Implications of Farydak & Kalydeco

13 Jun, 2015 0.

In February 2015, the FDA approved Farydak, a new treatment for multiple myeloma. The drug’s wholesale price: $6,860 for a 21 day cycle. But note that unless a health plan

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

24 Apr, 2015 0.

HR Execs: Do you think your PBM's shake-down of hepatitis C manufacturers really decreased your health plan's costs? If so, you should follow Ronald Reagan’s approach with the Russians: "Doveryai

End Unnecessary Costs From Your PBM’s Refill Pill Mill

21 Mar, 2015 0.

  Ask any of your employees, and you’ll probably learn many are swimming in unused pills that need never have been dispensed. “Pills – pills – and more pills,” they’ll

HR Execs: Take Note Of Hepatitis C Realities

08 Jan, 2015 0.

During the final days of 2014 and first week of 2015, newspapers around the nation announced three new developments that purportedly changed the prescription coverage world: On December 19th, the

Make Sure Your Plan Continuously Monitors – and Responds to – Newly Approved Rx Drugs !

21 Oct, 2014 0.

Rx Alert - October 2014 The drug marketplace is constantly changing, and new prescription drugs are continually entering the marketplace. To protect your plan beneficiaries' health - and your Plan's

Beware of Claims Data Errors – They Have Serious Implications!

13 Aug, 2014 0.

It’s critically important that every health plan monitor its claims data to determine whether claims data errors are allowing your PBM to overcharge for drugs and misrepresent whether the PBM

Controlling Compound Drug Costs

15 Apr, 2014 0.

Rx Alert - May 2014 Careful monitoring of new clients' claims data reveals an abundance of new, high cost Compound Drug creams. The creams - purportedly to address problems like