August 2009

Coverage often straddles the line between the pharmacy and medical benefit, but a properly constructed formulary can bridge the gap
Radiology benefit management programs and the launch of new guidelines may slow utilization
Unfortunately, most contracts practically invite the companies that health plans deal with to manipulate prices
A ‘health insurance czar’ might not make the final bill, if there is one, but the proposal evokes centuries-old tension
Legislators are looking closely at ways to prevent fraud and enforce new marketing and educational regulations

 

Departments
LEGISLATION & REGULATION
Just who gets paid for what — and how much — is expected to change in a big way in 2010
MEDICATION MANAGEMENT
The FTC warns that the competition between ‘follow-on’ biologics and the pioneer products is likely to be of the brand-vs.-brand variety
COMPENSATION MONITOR
TOMORROW’S MEDICINE
This competitor of clopidogrel will probably be most useful for patients in the initial phases of acute coronary syndrome
PLAN WATCH
Retail stores offer “young invincibles” and the working poor the chance to examine low-cost coverage options

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