Reference Pricing — Coming soon to a health plan near you?

There is great interest in reference pricing in the US for select medical procedures and branded drugs. While only 10% of mid-sized and large employers are utilizing reference pricing, more than 2/3 of employers have an interest in this payment technique. If it takes hold, there is a potential impact on utilization, revenue and quality of care that manufacturers will need to address.

MedSpan Musings — Tips for better payer market research

MedSpan Musings — Tips for better payer market research  

The benefit covering a drug is not always obvious

When discussing benefit coverage of drugs with payers, remember that some health plans at first cover drugs under the medical benefit and then transfer those costs each month to the pharmacy benefit. Be sure to probe for this approach and its implications for drugs administered in physicians’ offices and alternate sites of care.

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Gene therapy — The price is right?

The introduction of the first gene therapy presents challenges for payers. These costly therapies will require new approaches in terms of pricing benchmarks and reimbursement methodologies.

MedSpan Research Pay-For-Performance Case Study

MedSpan Research Pay-For-Performance Case Study http://wp.me/pReqv-m:

Connectivity is one of the Key Underlying P4P Programs…Read more to learn why

MedSpan Research’s Managed Markets Perspectives

MedSpan Research’s Managed Markets Perspectives: Pay For Performance Programs are becoming more prevalent. Dialysis facilities are already using this type of reimbursement program to improve on quality measures.