We recently sat down with Insurance Business America to share our insights into the increasing cost of specialty drugs and its impacts on payers and risk managers. Our senior sales associates, Mike Gold and James Hughes, discuss how predictive analytics can be a solution to this rising industry problem. “Predictive analytics not only allows us to price for the known risks, but by virtue of looking at quantitative and qualitative data surrounding each person within a population, we are able to predict that risk with our emerging flags.” ➡ Read the full article here: https://lnkd.in/g-bhBahk
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Global Legal Operations Executive | Operations & Strategy Leader | Former Legal COO @ Global 500 company | International NGO Board Member | Legal Innovator | Corporate Lawyer | Public Speaker | Bilingual
🗣️ Debate topic: should strategic business decisions be ethical❓ This new deal in the insurance world is an interesting case study. By restricting coverage to only 1 distribution network for “around 260” specialty medication in a class that is “meant to treat complex, chronic or life-threatening conditions”, this insurance company: ✅ will likely increase revenue as it creates a competition war for its services among pharmacies. And to achieve this business result, 🛑 actively chose to deny access to their insured, paying clients in need who don’t have easy access to this one network. ***** UPDATE Feb. 6th ****** A week after announcing the deal, the insurer backs out of it in the face of public backslash. https://lnkd.in/gsjFzTD2 #BusinessEthics #AccessToCare
Manulife-Loblaw deal to deliver specialty drugs sparks access, competition concerns - BNN Bloomberg
bnnbloomberg.ca
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Next episode in the Backbone story (aka Basic Policy 2024) in discussion at the Cabinet level yesterday and reported in the press. The Cabinet Office presented a draft of the Basic Policy for Economic and Fiscal Management and Reform (Basic Policy 2024) at the Council on Economic and Fiscal Policy. The policy includes a mid-year drug price revision for FY2025, promoting innovation and sustainability of universal health insurance. Minister of Economy and Finance Yoshitaka Shindo expressed concern about the drug lag loss in the domestic pharmaceutical industry, but he admitted that the drug price system is being discussed by the MHLW as a way to remedy this situation. There are a few innovative suggestions among the key proposals such as the policy calls for discussions on fixed-price drug copayments, or setting copayments according to the type of drug, and reviewing insurance benefits for drugs similar to over-the-counter products. The plan also promotes structural reform, industry restructuring, and the use of biosimilars. It also calls for insurers to investigate impediments to promoting refill prescriptions and raises awareness through individual notification by insurers. #pharmaindustry #drugspricing #healthinsurance #drugsupply #healtheconomics
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(WALL STREET JOURNAL) - "FDA Approves Eli Lilly’s Mounjaro For Weight Loss In The U.S. Under The Name Zepbound." The FDA’s green light will probably increase the already strong demand for the drug. It will also add to pressure on commercial health plans to cover the weight-loss use, despite the costs. Finally AFFORDABLE Health Insurance Plans At: HI4E.org #Mounjaro #Zepbound #MedicarePartDDrugs #MedicareDrugCoverage #Wegovy #Ozempic #Tirzepatide #NovoNordiskProfits #WeightLossDrugTirzepatide #FatBodies #WeightLossDrugs #Obesity #EliLillyWeightLossDrug #WeightLossShot #ObesityDrugs #WeightLossInjections #MedicareObesityDrugs #BrainPowerWithWeightLoss #WeightControl #InflammatoryResponses #HI4E.Org #HealthAndLifeSolutionsLLC #EliLillyProfits #WeightControlAidsBrainHealth #OverweightPeople #WeightLoss #CalorieCounting #Obesity #OverweightAdults #ObeseSeniors #HealthyLivingTips #WeightWatchers #HealthInsuranceForEveryone #WallStreetJournal
Eli Lilly’s Mounjaro Approved for Weight Loss in the U.S.
wsj.com
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Pfizer Agrees to Settle Over 10,000 Zantac Lawsuits https://lnkd.in/ebQmctWR Sometimes, the unpredictable happens. BEFORE a lawsuit is upon you, let Strong Tower Insurance have your back with solid coverage for when you need it the most. (813) 708-0001 https://lnkd.in/gyfuTRSQ #StrongTowerIns #StrongTowerInsurance #DirectorsInsurance
Pfizer Agrees to Settle Over 10,000 Zantac Lawsuits - ProgramBusiness | Where insurance industry clicks
https://programbusiness.com
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(WALL STREET JOURNAL) - "Exclusive: Medicare’s Drug-Price Talks Are About To Get More Heated." Companies and officials are already preparing for negotiations over more drugs that could take a bigger bite out of high drug costs, and possibly their bottom lines. Next up are prices of 15 more drugs the government will identify by Feb 1st. Finally Access To AFFORDABLE Health & DENTAL Insurance Plans At: HI4E.org #MedicarePartD #MedicartDPrescriptions #OpenEnrollment #MedicareDonutHole #MedicareOpenEnrollment #DrugNegotiations #TrumpMedicareReforms #HI4E.Org #PhRMA #BidenHealthcare #TrumpHealthcareReforms #HighDrugPrices #BidenDrugPriceNegotiations #ObamacarePlans #HealthInsurance4Everyone #DrugPrices #ObamacareOpenEnrollment #ObamacareSignUps #MedicarePartD #CanadianDrugs #DrugPriceNegotiations #HealthInsurance4Everyone #WallStreetJournal #HealthAndLifeSolutions #MedicareDrugs
Exclusive | Medicare’s Drug-Price Talks Are About to Get More Heated
wsj.com
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Best practice tip, are you ready? Do the Benefit Investigation. Insurance can approve anything that meets it's clinical guidelines, but is it actually covered? Understanding your patient's benefit specific coverage, financial responsibility and prior authorization requirements, all start by making a call (or chat, if you're lucky!). We have the best practices down, adapt them as the landscape to access changes and have a team ready to keep you informed. educated and prepared. Link: www.medico.cx . . . . . . #bestpractices #benefitinvestigations #medicalbenefit #pharmacybenefits #insurance #knowledge #coverage #biologics #sme #specialtymedication #access #buyandbill #specialtypharmacy #education #injectables #community #gpo
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[Webinar] Weight-Loss Drugs, PBM Alternatives and Other Pharmacy Solutions You may see the headlines about the rising cost of specialty drugs and the growing complexities of offering prescription benefits in an inflation-prone world. Our experts will cover these and other subjects, giving you tips for navigating them effectively. Join us on February 15: https://ow.ly/7HBM50QwQu8 #employeebenefits #ebwithryan #benefits #hr #humanresource #humanresources #insurance #aleragroup #hrhouston #healthinsurance #CFO #CFOinsights #CHRO #Texas #Houston
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