The Institute for Clinical and Economic Review (ICER) is a non-profit organization that weighs the costs of prescription drugs against their clinical and social value. Their method is complex, but essentially it designates drugs as "high value" if they deliver an additional, quality-adjusted life year (QALY) for less than $50,000, and "low value" if the [...]
Chronic diseases may affect many members, and these conditions can be costly to employers. Although the prevalence of complex, chronic diseases is low, the conditions can be costly. In an attempt to manage direct health care costs, many employers have turned to high deductible health plans (HDHPs) with health savings accounts (HSAs). Unfortunately, members [...]
How do Co-pay Accumulator Adjustor Programs (CAAPs) affect the refill adherence and discontinuation of specialty medications? Members in HDHPs with HSAs often meet their entire deductible within the first few months of the year if they are taking a specialty medication. Because of the need to have funds to cover this entire amount so [...]
Without key, cross-silo information, employers that implement medical cost controls via pharmacy plan design for employees run the risk of discouraging treatment essential to employees’ health-related productivity and quality of life. This IBI study, relying on a master database furnished by Ingenix, demonstrates the unanticipated consequences in in
