DRUG COSTS

Out of control—or delivering value?

Pharma innovation isn’t free—but few believe the sick should bear the costs. Balancing costs and benefits requires data, collaboration, and the courage to try new things.

Efficacy within reach

Is affordability a pipe dream?

As drugs become more sophisticated and targeted, they often become dramatically more expensive. Even common drugs can see massive price increases when patents change hands or new uses are found.

As our healthcare systems and patients bear the cost of pharmaceuticals, how do we create a system that is fair to all—especially those whose lives could be saved by greater availability of medications?

landmark legislation

Healthcare changes in the Inflation Reduction Act

From negotiated drug prices to Medicare Part D redesign, our research and analysis break down the law’s implications for plan sponsors, health plans, and pharmaceutical manufacturers.

Read our insights

Infographic

Payer strategies for weight-loss medications

Demand is up for drugs like Wegovy and Ozempic. How can plans balance the potential health benefits with adherence challenges and waste?

View the article and infographic

Article

Controlling Rx costs: Top 5 reasons for a PBM RFP

Five reasons why RFPs with PBMs should be a regular practice to help control Rx costs.

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article

How blockchain technology will disrupt the PBM-payer-pharmacy relationship

Where there is complexity and unequal access to information, there is often room for increased efficiencies and opportunities for disruption.

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article

A primer on prescription drug rebates

Insights into why rebates are a target for reducing prices

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Article

Impact of the Inflation Reduction Act on plans seeking creditable coverage

The Inflation Reduction Act’s higher standards for retiree prescription drug plans may require plan sponsors to enrich benefits in 2025 for creditable coverage.

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White paper

Average Manufacturer Price cap removal: Implications for state Medicaid programs

As a new federal law, effective in 2024, removes a cap on manufacturers' drug rebate amounts, we explore the implications for state Medicaid programs.

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WHITE PAPER