New Valuable Pharmacy App Solves a Big Problem

Pills on US dollars.

Why does pharmacy have to be so difficult? There seems to be a huge disconnect and a lot of finger pointing when it comes to prescribing drugs. A patient goes to the doctor and at the end of the visit gets prescribed medication to address the issue. Patients accustomed to the drill start to sweat… [Read More]

Another Band-Aid: Pharmacists Shopping for Patients

Cropped shot of shelves in a pharmacy

As anyone who has ever filled a prescription knows, the arcane and mind-numbingly complex pricing framework for drugs makes it both impossible to know what the drug will cost in advance of filling the prescription and similarly challenging to shop for a lower-cost alternative. With hundreds, if not thousands, of pharmacy benefit manager (PBM) and… [Read More]

Walmart-Humana and the Future of Healthcare

Fast speed dataflow.

Change and consolidation continue to sweep the insurance industry. Healthcare represents almost 20% of the U.S. economy. Costs are increasing and almost no one is happy. These are ingredients for change. The retail sales portion of the economy is also under extreme pressure – with thousands of stores closing and wildly-moving stock prices, this market is as ready for drastic… [Read More]

A Conversation with Dave Cordani, President and CEO of Cigna, About Express Scripts

White Speech Bubble Hanging on the Green Background

I had the opportunity to talk to Dave Cordani, President and CEO of Cigna regarding their planned purchase of Express Scripts. The health insurance carriers get it – they very much need to bring solutions to the market or solutions, which may not be optimal to the carriers, will be imposed upon them. Cigna’s intent is to create… [Read More]

Message Heard – Pharmacy Costs are in the Spotlight

Rx Prescription #2

No doubt the health insurance carriers are getting the message: pharmacy costs are too high, and pricing is not transparent. UnitedHealthcare has announced that they will begin passing rebates directly to retail purchasers at the point of purchase. Pharmacy rebates – which are usually shared between the pharmacy benefits manager (PBM) and the health insurer… [Read More]

A Few Suggestions to Simplify Healthcare

Path or way from A to B - solution strategy concept

I keep waiting for Bezos-Buffet-Dimon to call me (I know they will one day) but in the meantime, cyberspace is a good place to share my thoughts on healthcare redesign. The front door to healthcare delivery should be an easy-to-use smartphone application which is pre-populated with a healthcare calendar, set up with you and your doctor, to remind you… [Read More]

Can You Believe What Happened to Me at the Pharmacy?

pharmacy counter with blur shelves of drug in the pharmacy drugstore background

This is going to be a rant blog. I happen to know that a lot of people from Aetna (which is my insurer) read this. But, it really doesn’t matter whether it’s Aetna or another medical insurer – they all have the same issues. Thankfully I am reasonably healthy. As with most people, my most frequent encounter with the… [Read More]

CVS-Aetna – a Few Weeks Later

Doctor sitting at table and working with tablet. Medical icons in hexagonals in front. Only hands seen. Concept of medical help.

So the CVS-Aetna deal has been seasoning a bit and I really haven’t heard of any major roadblocks to approval. And early integration planning is starting. Not that integration teams are that much of an indication as they didn’t portend a good result for the Aetna-Humana or Anthem-CIGNA mergers. It would seem that horizontal integration is… [Read More]

A Call to End Drug Rebates

Drug Cost  Specialty Pharmacy

Healthcare can be transformative and the ability to extend and improve life continues to rapidly roll in. But while medical advances are explosive, our creative skills in controlling costs proceed at a snail’s pace. I realize that change is hard, but it boggles my mind that we can’t take simple steps to reduce cost trends. Regulating drug… [Read More]

Are Drugs Cheaper Using Cash?

The concept of paid medicine with pills on a money background

This past weekend, a far-reaching exposé was published by the New York Times and ProPublica highlighting how, in many instances, individual members can save money paying cash when compared to using their insurance for their generic prescriptions. While this is not a new issue, the investigation reviewed the top one hundred prescribed medications, finding that 40% of the time… [Read More]