Article Biosimilars Insurance Coverage and Processing 
Pharmaceutical Commerce
JUNE 17, 2025
Artificial intelligence addresses key limitations of traditional health technology assessments—such as data gaps and time-intensive processes—through automation, real-time data integration, and advanced predictive modeling, leading to faster and more informed decisions. AI supports personalized medicine and real-world evidence integration.
Pharmacy Times
JULY 16, 2025
Importantly, ACIP’s recommendations do have a strong influence, if not a mandate, on health insurance companies with respect to coverage and co-payments for immunizations as well as the Vaccines for Children Program, which provides coverage for access to vaccines for those who are 18 years or younger.
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Pharmacy Times
AUGUST 11, 2025
Most MTM platforms use health plan adjudication data, allowing pharmacists to see any medication billed through the patient’s insurance, even if it was not filled at their pharmacy. Because documentation of medication lists is a key component of MTM, pharmacists are well positioned to incorporate this into transitions of care.”
Pharmacy Times
JULY 22, 2025
These third-party administrators act as intermediaries between drug manufacturers, pharmacies, and insurance companies. PBMs negotiate prices, establish formularies, and process claims, while also creating preferred networks of pharmacies. Additionally, the role of pharmacy benefit managers (PBMs) cannot be overlooked.
Pharmacy Times
JULY 25, 2025
First-generation oral cephalosporins (ie, cephalexin and cefadroxil) have excellent coverage of methicillin-susceptible S aureus and Streptococcus spp, making them ideal agents for treatment. They occur frequently in the community and are most often caused by S aureus and Streptococcus spp.
Pharmacy Times
JULY 1, 2025
SHOW MORE Pharmacists can help oversee the treatment process to ensure patients with transthyretin amyloid cardiomyopathy (ATTR-CM) are adhering to tafamidis. Ongoing research explores tafamidis' long-term efficacy, potential in other heart failure forms, and combination therapies for enhanced outcomes.
Pharmacy Times
JULY 22, 2025
Personalized drug selection can lead to faster symptom control, fewer hospitalizations, and improved adherence—all of which contribute to better outcomes and a more streamlined care process.
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