Pharmaceutical Commerce

OCTOBER 2, 2023

Kirsch discusses the complexity of the drugs and the verification process, along with Eversana’s new platform, ACTICS eAccess.

52

52

Express Pharma

AUGUST 31, 2023

Some are also maintaining insurance with respect to cybersecurity.” The companies doubt if such coverage will be commercially available, or if that coverage will pay future claims.

Insurance Coverage and Processing 104

Insurance Coverage and Processing Pharmaceutical Companies Pharmaceutical Companies 104

Community Pharmacy

NOVEMBER 30, 2023

Created as an insurance coverage plan for those over 65, Medicare offers four levels of benefits that cover everything from hospital insurance to prescription medicine costs. 2024 Medicare Part D Costs Updates While the cost of Part D insurance premiums is expected to decrease from an average of $56.49 in 2023 to $55.50

Insurance Coverage and Processing 52

Insurance Coverage and Processing Community Pharmacies Hospitals 52

Pharma in Brief

JULY 19, 2023

CADTH Time-Limited Reimbursement Recommendations Starting in the fall of 2023, CADTH, which conducts health technology assessments ( HTAs ) to inform public insurers, will introduce time-limited reimbursement recommendations for certain drug products. CADTH intends to align this process with Health Canada’s proposed agile licensing reforms.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Drug Pricing 40

STAT

AUGUST 17, 2023

Bancel is in the process of donating a vast majority of his income to charities. That CEO haul was down 11% from the $4.5 billion recorded in 2021. The 10 highest-paid CEOs — a list that also includes the CEOs of Thermo Fisher and McKesson — made a combined $1.4 billion, or about a third of the total studied.

Insurance Coverage and Processing 246

Insurance Coverage and Processing Nursing Homes Prescription Filling Hospitals 246

STAT

MARCH 26, 2024

Novo Nordisk plans to seek coverage by Germany’s public health insurance scheme for the use of its Wegovy drug to cut the risk of strokes and heart attacks, if the extended indication wins European approval , Reuters notes.

Drug Pricing 198

Drug Pricing Insurance Coverage and Processing Diabetes Pharmaceutical Companies 198

Integra X Files

MAY 22, 2023

Prior authorization has been popular with the insurance industry because it works. This is known as the sentinel effect, and in the initial stages, providers accommodated the process without much complaint. The health insurance industry didn’t have many other tools to suppress demand, so it went with the sentinel effect by default.

Insurance Coverage and Processing 94

Insurance Coverage and Processing Health Insurance Companies 94

Putting Patients First Blog

JANUARY 16, 2024

The NBPP is a set of rules and guidelines issued annually by CMS that outline the policies and standards for health insurance plans and issuers, primarily focusing on the Health Insurance Marketplace under the Affordable Care Act. These are the rules for the federal health insurance marketplace for the coming year.

Insurance Coverage and Processing 59

Insurance Coverage and Processing Communication 59

Community Pharmacy

NOVEMBER 15, 2022

If this applies to you, then you can begin your application process here to get the process started. Medicare Part D has four phases of coverage that users need to be aware of before and during enrollment in the program. In 2022, the initial coverage limit was $4,430. In 2022, the coverage gap limit was $7,050.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Community Pharmacies Vaccines Hospitals 52

Putting Patients First Blog

MARCH 15, 2024

ERISA is long overdue for Congressional attention, and we appreciate that the RFI starts this process. Patients need an affordable, functioning employer-sponsored insurance (ESI) system. It is additionally important to note that many of the people covered by private insurance have disabilities.

Insurance Coverage and Processing 40

Insurance Coverage and Processing 40

Express Pharma

SEPTEMBER 6, 2023

To help financially weak citizens gain access to affordable healthcare, the Pradhan Mantri Jan Arogya Yojana (PMJAY) was launched in 2018, providing about 500 million Indians with a ₹5 lakh family health insurance cover that include coverage for 1,400 medical procedures as well as critical diseases like prostate cancer.

Insurance Coverage and Processing 59

Insurance Coverage and Processing Biosimilars Generic Medicine Drug Pricing 59

Birth Control Pharmacist

JANUARY 19, 2023

Certification Requirements Here are some of the most important steps to the certification process that pharmacists should know about. By providing guidance on other aspects of the abortion process, such as follow-up care and contraception options, pharmacists help to ensure that patients have a safe and successful abortion experience.

Insurance Coverage and Processing 83

Insurance Coverage and Processing Health and Personal Care Stores Mail-Order Pharmacies Packaging 83

Digital Pharmacist

JANUARY 26, 2023

This is helpful for saving patients money, but because Amazon Pharmacy is not processing the prescriptions through insurance, the medications will not fully show on patients’ insurance profiles. ❌ RxPass is not Available Nationwide RxPass is currently only in 42 states and Washington, D.C.

Insurance Coverage and Processing 95

Insurance Coverage and Processing Independent Pharmacies Online Pharmacies Scheduling Appointments 95

Putting Patients First Blog

JANUARY 4, 2024

The Abdominal Core Health Quality Collaborative (ACHQC) believes it is our obligation to listen and offer suggestions to help patients navigate the decision-making process. Choose a surgeon who communicates clearly, listens attentively, and ensures you understand the procedure, potential risks, and recovery process.

Insurance Coverage and Processing 89

Insurance Coverage and Processing Communication Hospitals 89

PharmaShots

JUNE 2, 2023

Anas Batikhi: The healthcare sector, an ongoing evolving industry on its own, is simply a flowing stream of processes, revenues & valuable health outcomes. Getting this process wrong is detrimental to any revenue collections resulting from availing services to the patient.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Health and Personal Care Stores Medical Records Documentation 40

pharmaphorum

JUNE 27, 2022

Jennifer Mathieu, director of government relations at the Academy of Managed Care Pharmacy (AMCP), tells us why the organisation backed the pre-approval information exchange (PIE) Act of 2022 and how the legislation will empower companies to share information with healthcare payers and plans during the FDA approval process. .

Insurance Coverage and Processing 73

Insurance Coverage and Processing Communication 73

pharmaphorum

FEBRUARY 4, 2022

“We’re disappointed with the position that [CMS] has taken in its draft national coverage determination decision,” said Lilly’s chief scientific and medical officer Dan Skovronsky on the call, adding that it “essentially negates” the intention of providing patient benefit in areas of unmet medical need.

Insurance Coverage and Processing 82

Insurance Coverage and Processing Diabetes 82

Putting Patients First Blog

OCTOBER 15, 2023

As the primary insurer for millions of Americans and as the programs that drive decisions throughout the health ecosystem, these federal programs can be a critical driver of innovations. Finally, the timing of the scoring process can be frustrating when working to advance good policy. Best Price).

Insurance Coverage and Processing 40

Insurance Coverage and Processing 40

Putting Patients First Blog

FEBRUARY 1, 2024

System-Wide Public Transparency One likely policy to be included in a health care package is increased transparency into health care costs and coverage, which is a priority of the patient community. The House passed H.R. 5378 More Transparency, Lower Costs Act in December 2023.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Packaging Hospitals 52

Putting Patients First Blog

MARCH 29, 2023

Provisions to Ensure Coverage During Future PHEs The pandemic has underscored the importance of meaningful, affordable health insurance coverage. Making sure that the greatest number of people possible have coverage during a PHE is critical to assuring that patients and our health care system are protected during a PHE.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Vaccines Documentation Hospitals 40

The Digital Apothecary

AUGUST 15, 2017

Pharmacy has drastically changed, and with the patient view of most pharmacists just 'Count-Lick-and Pour' medications for patients it's not hard then to think of how to just automate the process. One issue is that the dispensing process is not a full-proof system at the current time. Which, to be honest, is a thing right now.

Mail-Order Pharmacies 130

Mail-Order Pharmacies Insurance Coverage and Processing Health and Personal Care Stores Medication Dispensing 130

Putting Patients First Blog

JANUARY 10, 2024

Making available more specific information about total costs and coverage will ensure that all consumers have comprehensive information to help them make smart health care decisions. These resources should aim to clarify insurance terms and concepts, aiding consumers in navigating the complexities of selecting a health plan.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Documentation Diabetes 40

Ramblings of a pharmacist

APRIL 23, 2023

Separately, I don’t believe that 90-day supplies actually drive true adherence or clinical improvement - they just move the process measure of PDC. And downstream health effects of PBM coverage decisions don’t even enter into the spreadsheet - PBMs are about drug cost, and drug cost alone. They do… to a point.

Insurance Coverage and Processing 76

Insurance Coverage and Processing Independent Pharmacies Diabetes Health Insurance Companies 76

Pharma in Brief

FEBRUARY 2, 2022

In Canada, coverage for prescription drugs exists through an array of public and private drug plans. The Panel’s mandate did not include governance structures, financing, patient eligibility, or the interplay between public and private insurance plans. Background. a formulary); and. a formulary); and. Drug cost was not a consideration.

Insurance Coverage and Processing 59

Insurance Coverage and Processing Biosimilars Diabetes 59

Putting Patients First Blog

MARCH 4, 2024

Ensure Comprehensive Transparency in Formulary Management: Provide clear, comprehensive guidelines to Part D plans to ensure transparency in plan coverage, tiering, and utilization management (UM) policies, offering safeguards against practices that could restrict access to necessary treatments.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Hospitals 40

Putting Patients First Blog

JUNE 5, 2023

This is not a venue that patients and their advocates have access to, as health insurance plans are the primary users of the portal. CMS must ensure stakeholders have ample opportunity to provide input throughout the implementation and adjustment process. A simple 30-day comment period process will likely not be sufficient.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication 40

Putting Patients First Blog

MARCH 4, 2024

Under the new Manufacturer Discount Program, manufacturers will be required to provide discounts on applicable drugs during the initial coverage phase and catastrophic phase of the defined standard Part D drug benefit.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Hospitals 40

pharmaphorum

JULY 19, 2021

While recent years have seen an increase in the number of people who are insured, growth in out-of-pocket costs for many people with commercial insurance has outpaced growth in health plan costs, and premiums continue to rise. Right now, many of the sickest patients are burdened with most of the costs. We all need to do better.”.

Insurance Coverage and Processing 105

Insurance Coverage and Processing Vaccines Documentation Immunity 105

Proxsys Rx

SEPTEMBER 26, 2023

Even with her insurance coverage, the co-pay was beyond her means. The gentleman in question had no health insurance coverage at all, and the cash price for his prescription was far beyond his means to pay. Our pharmacists were only too happy to help.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Hospitals Prescription Filling Specialty Pharmacies 52

pharmaphorum

OCTOBER 1, 2022

In this latest coverage, pharmaphorum speaks with Eugene Borukhovich. If we look at insurers, during the kind of peak of the pandemic, insurers were not paying out, so, there was in theory lots of cash saved up for further investments. Augmented by technology, but not replaced by technology throughout that process.”.

Insurance Coverage and Processing 85

Insurance Coverage and Processing Hospitals 85

pharmaphorum

APRIL 29, 2021

Officially launched in 2016, Kaia’s technology can now be accessed by 60 million patients worldwide and it claims to be the biggest player in digital MSK in terms of coverage. The benefits of insurance firms are focused on main HQ offices.”. billion invested in the sector in Q1 alone. Reimbursement expected in Europe.

Insurance Coverage and Processing 62

Insurance Coverage and Processing 62

Proxsys Rx

NOVEMBER 8, 2023

Even with her insurance coverage, the co-pay was beyond her means. The gentleman in question had no health insurance coverage at all, and the cash price for his prescription was far beyond his means to pay. Our pharmacists were only too happy to help.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Hospitals Prescription Filling Specialty Pharmacies 40

European Pharmaceutical Review

MARCH 28, 2024

When Aidan’s insurance company denied coverage for EXONDYS, the data she captured overturned the denial in 24 hours without engaging in the appeal process. That PRO programme then proved instrumental in the approval of EXONDYS51, the first FDA-approved treatment for Duchenne.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Packaging Communication 52

FADIC

OCTOBER 24, 2023

FDA approval process The FDA regulates both OTC and prescription drugs, but in different ways. Prescription drugs have to go through the New Drug Application (NDA) process. The application includes submitting clinical drug trial data and information about the manufacturing process.

Health and Personal Care Stores 52

Health and Personal Care Stores Insurance Coverage and Processing Labelling Dosage 52

pharmaphorum

AUGUST 31, 2021

In constructing an ECA, there are additional processes involved, such as planning the best study design, selecting the highest-quality clinical RWD source, defining the most appropriate inclusion/exclusion criteria, and conducting all necessary analyses to ensure the synthetic cohort is well matched to the experimental cohort. .

Insurance Coverage and Processing 63

Insurance Coverage and Processing Drug Development Documentation Labelling 63

pharmaphorum

NOVEMBER 1, 2022

Open protocol, simply put, is a digital language that facilitates electronic transactions among prescribers, pharmacies, patient support vendors, data aggregators, insurers, and other stakeholders in the specialty pharmaceutical patient journey. The patient’s journey is typically long and complicated ?

HIPAA 97

HIPAA Insurance Coverage and Processing Specialty Pharmacies Communication 97

Putting Patients First Blog

JULY 3, 2023

We encourage the CMS to engage providers and patients in this process to decrease the overall burden on and encourage provider participation. This includes addressing workforce shortages that may lead to longer wait times. In addition, standards should be aligned with the capacity of payers and providers.

Insurance Coverage and Processing 40

Insurance Coverage and Processing 40