Pharmacy Toolkit

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  • 5/30/2019
  • Presentation: Management of biosimilars across the enterprise
  • Presbyterian Health Plan shares an overview of the process utilized with key medical group stakeholders in Gastroenterology & Rheumatology to develop and implement practice guidelines and protocols for the use of biosimilars across the enterprise.
  • 5/30/2019
  • Presentation: Oncology utilization management
  • Scott & White Health Plan implemented a successful solution to address the challenge of cost management and benefits review for oncology services, presented at the Pharmacy Summit May 30, 2019.
  • 5/29/2019
  • Presentation: Opioid overuse strategies
  • Sentara & SelectHealth share overviews of the programs and strategies they have employed to address both acute and chronic opioid overuse, detoxification programs in addition to prescriber interventions. Presented at the pharmacy summit held in Dallas on May 29 and 30, 2019.
  • 5/29/2019
  • Presentation: Specialty Pharmacy Management Strategies & Innovations
  • The cost of specialty pharmacy is a rising concern for patients, providers, and payers. Cooperative Benefits Group reviews specialty trends in both cost and utilization as well as the drivers of specialty Rx growth and innovative approaches to reducing spend.
  • 4/22/2019
  • Alternative Models for Pharmaceutical Rebates
  • The combination of rising drug costs at the health system level and increasing financial stress for individual patients has triggered intense national concern. One target has come under particular scrutiny: rebates. This white paper provides policy perspectives on alternative models for pharmaceutical rebates.
  • 12/11/2018
  • 2018 Alliance Pharmacy Benefits Survey
  • Results of the 2018 survey of Alliance member pharmacy leaders covering pharmacy operations, vendors used, challenges, prioritiies, and topics desired for future Alliance programming.
  • 12/7/2018
  • Opiod Education Member Letter
  • SelectHealth shares a member communication summarizing Medicare changes to opioid prescriptions, effective January 1, 2019.
  • 11/2/2018
  • Presentation: Changes coming that will impact pharmacy costs - MA Part D focus
  • Milliman expert Katie Holcomb discusses the types of changes that could be coming in the near future and what their potential impacts on pharmacy costs could be, with a particular focus on the Medicare Part D market. In recent years, pharmacy costs have received increasing attention, among insurers as well as legislators and the general public. CMS, MedPAC, HHS, and President Trump have all commented on potential ways to lower drug prices, reduce patient out-of-pocket costs, and improve care.