Tag Archives | pharmacy benefit management

Quick Reference Guide to Drug Utilization Reviews [Infographic]

The 21st Century Cures Act, the opioid crisis, and the cost of pharmaceuticals dominated the headlines of 2016, highlighting the importance of understanding how prescription drugs work in today’s healthcare industry. One valuable tool used by employers, health plans and pharmacists is Drug Utilization Review (DUR). AMR created a quick reference guide to DUR so you […]

Reimbursements Driving Better Clinical Outcomes in Behavioral Health

Over the past few years, America has witnessed its health care system shift from a predominately pay-for-service model to one with various reimbursement models that focus on long-term behavioral health improvements, promoting efficiency and reducing costs. It may seem like a tall order for physician payment methods to improve patient care, but the industry agrees […]

The Latest Facts on the Mental Health Crisis in America

Mental Health

Approximately 43.6 million adults in the U.S. suffer from some type of mental illness, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). That is more than 18 percent of the U.S. population. At that rate, it’s nearly impossible for someone to go their whole lives without either experiencing mental illness first hand […]

Opioid Study Shows the Danger is in the Dosage

In the U.S., prescriptions for and sales of opioid painkillers have nearly quadrupled since 1999, according to the Centers for Disease Control and Prevention. Researchers from the University of Michigan Medical School and the Department of Veterans Affairs’ Ann Arbor Healthcare System published a new study in the online journal Medical Care exposing a major […]

FDA’s Drug Approval Process – How it Fits into the US Health Delivery System

The U.S. Food and Drug Administration has a rigorous drug approval method, but recent years have shown that even this thorough process undergoes certain trends. Each year more new drug applications (NDA) are submitted and approved, including specialty drugs. The annual increase in the approval rates of novel and specialty drugs may signal a general […]

PBMs: Past, Present and Future

Not every aspect of the shifting health care market is clear, but one thing is for certain: The importance of pharmacy benefit management companies (PBMs) is increasing. Drug prices are rising, and PBMs continue to act as intermediaries between insurance companies, pharmacies and manufacturers to reduce prices for insurers and patients whenever possible. PBMs have […]

Drug Formularies Reduce Costs, Gain in Popularity

Workers’ compensation drug formularies are not a new idea, but only a few states currently have such mandated formularies in place, according to an article in Claims Journal. Only Washington, Texas, Ohio and Oklahoma have previously existing state-regulated drug formularies. California is the most recent state to make the change. In early October, Governor Jerry […]

HealthCare Seeking Solutions for Specialty Drugs Costs

The Centers for Medicare & Medicaid Services predicted that spending on prescription drugs would rise by 6.8 percent in 2014.   Their estimate was a bit off.   Instead, spending on prescription medications leaped by 13 percent to $374 billion, according to a recent paper from the IMS Institute for Healthcare Informatics. It was the […]

Predicting Non-Adherence Could Lead to Patient Interventions

Catching a medication concern before it arises   Americans receive nearly four billion prescriptions each year. That’s a big number.   But they fail to properly use at least half of those prescriptions, or even take them at all. That’s also a big number — and a big problem for health care. Studies have found […]

Pharmacy Benefit Management Helping to Innovate Health Care

Pharmacy benefit managers (PBMs) may not be the most visible players in health care today. But these organizations have an important position in helping control drug costs in the United States, and they continue to take on new roles.   The traditional function of PBMs – which date back to the 1970s — is to […]

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