Insurers Digging Through the Numbers on Oncology Treatments

Insurers Digging Through The Numbers On Oncology Treatments

One of the most difficult issues we face as a society is the cost of care for people who are terminally ill. In fact, most of a person’s lifetime healthcare spend is incurred at the end of their lives. With the advent, and ongoing issue, of skyrocketing pharmaceutical costs insurers are looking closely at the… [Read More]

Justice Department Finally Turns Attention to Pharmacy Collusion


One of the biggest frustrations echoing from our postings over the last couple of years has been the covert, if not outright overt, collusion in the pharmacy market between drug manufacturers and in many instances the PBMs—pushing up the list cost of pharmaceuticals. This has been an issue hitting our clients’ wallets hard because although… [Read More]

Pharmacy Cost Confusion

Pharmacy Cost Confusion

What is going on with the pharmaceutical industry? Sometimes I feel like they are taunting all of us. I have been writing about the abuses the industry has been imposing on our healthcare system (see related posts here, here and here). There is a lot of subterfuge and non-transparency surrounding costs and the vultures are circling. Pharmacy Benefit… [Read More]

Is the Obama Roadmap for the Future of ACA on Track?

ACA graphic

In an article appearing in the Journal of the American Medical Association (JAMA), President Obama declared that the Affordable Care Act has been successful, and he also lays out a roadmap for his vision of the future. The article highlights three main points: While ACA has led to the expansion of covered Americans, it has not… [Read More]

Pharmacy Shenanigans

Prescription Drug Cost

In evaluating the cost of a medical benefits program, prescription drug costs and in particular, specialty drugs, stand out as the fastest growing and the most difficult to manage cost. As I review programs with clients, I find myself often pointing out that pharmacy is where all the profits are hidden. This has been no… [Read More]

Controlling Specialty Drug Spending

Drug Cost  Specialty Pharmacy

Another commentary from the National Blue Cross Consortium. As I mentioned in prior posts, large claims are on the rise. Last year, Blue Cross paid their first individual claim for more than $15M, and the frequency of claims over $1M tripled from 2010 to 2015. Specialty medications are a real focus area. There is a… [Read More]

The New Media Focus Is Pharmacy – Can Regulators Keep Up?  How Should Employers Protect Themselves? 

Drug Cost  Specialty Pharmacy

Turing Pharmaceuticals – the vilified hedge fund-owned prescription drug peddler that increased the cost of their 62-year-old drug from $13.50 to $750 per tablet overnight – has raised new cries for the legislative involvement in pharmaceutical costs which I have been writing about for a while (see related posts here, here and here). A recent Reuters study… [Read More]