PBM Challenges: How To Improve Transparency and Efficiency in Healthcare

healthcare worker typing on laptop

It is no secret—there is a complex value chain in healthcare. It’s also fair to say sometimes a patient’s needs get lost in the shuffle. Pharmacy benefits managers (PBMs) are an integral go-between among pharmacies, hospitals, drug manufacturers, and providers. PBMs face the daily task of negotiating terms and prices, selecting which drugs are covered […]

How PBMs Manage the Costs of Ozempic & GLP-1 Drugs

Insulin injection pen or insulin cartridge pen for diabetics

The world of weight loss is always evolving, and a recent trend has caught the attention of many: the use of diabetic drugs, specifically GLP-1 drugs like Ozempic, for shedding the pounds. Originally developed to manage Type 2 diabetes, these drugs have found a new, off-label use in the weight loss arena. But this trend […]

How To Improve the PBM Value Chain

Man doctor using digital tablet

For companies operating in the complex healthcare environment, Pharmacy Benefits Management (PBM) is pivotal for charting the way forward. The PBM value chain is a series of interconnected activities and stakeholders, all working to ensure that pharmaceutical products are efficiently developed, produced, and distributed. This value chain determines drug pricing, reimbursement policies, and ensures patient […]

How Do PBMs Affect the Retail Pharmacy Industry?

pharmacist looking at medication

PBMs, or Pharmacy benefit managers (PBMs) are intermediaries between pharmacies, health insurers, and drug manufacturers. PBMs play a significant role in the retail pharmacy industry by managing prescription drug benefits for health plans, employers, and government programs. PBMs have been around since the 1960s and have a strong foothold in the healthcare sector. The relationship […]

Cost and Other Barriers To Medication Adherence

woman holding medication

When it comes to managing health, taking prescribed medication correctly and consistently is crucial. However, a significant number of people struggle with medication adherence and don’t take their medicines as prescribed. This situation can lead to serious health complications and higher costs for both patients and the healthcare system. One of the main obstacles patients […]

Healthcare Payer Analytics: A New Era of Care

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Digitalization is bringing the often disjointed operations of healthcare into closer union through healthcare payer analytics. As we edge toward a new synthesis of using data to drive better services, we see the potential for improved collaboration between providers, payers, and intermediaries. How Do Health Plans Take Advantage of Digitalization? Healthcare has entered the era […]

The Future of Biosimilars: What To Expect Next

Doctor taking pain and stress relief medicine to help with mental health during cover fatigue. Medical healthcare professional nurse showing the correct drug dose by pouring the pills in her hands

To discern the future of biosimilars, a look at how far innovation in biologics has come is helpful. Biologics have saved millions of lives over the years and raised the standards of living for tens of millions more. But modern pharmaceutical markets also bring complex challenges to healthcare. We will take a close look at […]

AI in 2023: How New Tech Is Shaping the Future

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In 2023, artificial intelligence (AI), analytics, and automation are rapidly transforming the way businesses operate and serve customers by: AI, analytics, and automation are fueling the exponential growth of new industries, such as the Internet of Things (IoT), autonomous vehicles, and smart cities. As these technologies continue to evolve and become more widely adopted, businesses […]

The Evolution of the PBM Business Model

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Pharmacy Benefit Managers (PBMs) play a crucial role in healthcare by managing prescription drug benefits for health plans, employers, and government programs. By leveraging scale and expertise, PBMs help to control surging drug costs, increase access to prescription drugs, and improve the quality of care for patients. Over the years, PBM business models have evolved […]

How To Analyze Claims Data: What You Need To Know

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As healthcare costs continue to rise, Pharmacy Benefit Managers (PBMs) are under increasing pressure to manage their clients’ drug spend, while ensuring patients have access to the medications they need. One of the most valuable tools at their disposal is healthcare claims data, which can deliver insights into patient behavior, healthcare utilization, and healthcare costs. […]