Serving managed care, health-system and specialty decision makers Volume 10 • Number 6 • November/December 2021 • specialtypharmacycontinuum.com
‘No good solutions’ for the patient
CLINICAL Promising regimens for hepatitis delta variant ....
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Drug testing gap another COVID-19 casualty? ................................
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PrEP regimens deemed essential for ending HIV ....................
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From interchangeables to injectables, a year of firsts in new drug approvals ............................
Pharma Grapples With Best Price Accumulator
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New Survey Finds Biosimilars Have Wide Acceptance Aurora, Colo.—Nearly two-thirds of managed care stakeholders polled in a recent survey said they are covering some biosimilar products, with most of them reporting “meaningful” cost savings from the formulary strategy. The survey findings underscore that biosimilars are finally coming into their own, and with their use, helping to conserve scarce health care dollars, according to presenters at the AMCP Nexus 2021 meeting. “When biosimilars first entered the market, there were a lot of unknowns,” said Tasmina Hydery, PharmD, MBA, BCGP, the assistant director of integrated technology solutions at Continued on page 30
POLICY 340B, PAPs come to the rescue during pandemic ............................
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OPERATIONS & MGMT
For health systems, many paths to specialty success ............ 36 Pharmacists manage the revenue cycle for home infusion ............
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As Managed Care Beat Goes On, How to Keep Up
he Centers for Medicare & Medicaid Services (CMS) has been busy on the copay front, with several of the agency’s recent decisions sions affecting how copay programs influence the he cost of medications. But three main stakeholders with skin in n the game—patients, providers and manufacactures—are expressing concern about the unintended consequences of these actions. CMS’s MS’s “best price copay” and copay accumulator policies ies seem to be at the center of the debate, based on sessions sions at InformaConnect’s 2021 annual Coupon & Copay Conference. Nearly 70% of respondents in a September t b 2021 survey off pharmaceutical manufacturers and other stakeholders, for example, conducted by Informa Engage, reported that they were moderately (53%) or very (16%) concerned that CMS’s best price copay ruling negatively affect their company, reported
he managed care market is in constant flux, so health-system pharmacy leaders need to be nimble and work with their managed care teams to maintain a competitive strategy, speakers said during the 2021 ASHP Conference for Pharmacy Leaders, held virtually. Megamergers are a big reason for the constant change, with payors such as UnitedHealth Group joining forces with or acquiring pharmacy benefit managers and pharmacies, said Paul Spencer, MBA, the vice president of managed care and revenue cycle services for Froedtert Health, in Milwaukee. “I don’t see this
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The stories behind the market players Special advertising section begins on page 15.
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Corporate Profiles
2022
