December 2014

For specialty medications, weighing cost and benefit can be frustrating. Some can dramatically reduce future costs. Others, not so much.
Joseph Burns
Beneficiaries and physicians can be surprised and dismayed to find that in some drug classes in some plans, there is no preferred agent at all
Joseph Burns
Health plans can capitalize on a range of shifting market forces, but should also refine programs for improving care, says this well-known author and consultant
John Marcille
They’re customized to local caseloads and conditions, they coordinate with primary care practices, and they focus on building trust with patients
Michael Levin-Epstein
Health plans often have to gauge the value of genetic and genomic tests and are forced to make decisions with imperfect information
Thomas Reinke



Departments
ACO Update
Hospital-led ACOS may have some advantages in the beginning, but the physician group ACOs may win out in the long run
Peter Wehrwein
Legislation & Regulation
Voters overwhelmingly approved an any-willing-provider law, striking a blow against narrow networks
Richard Mark Kirkner
Medication Management
Experts at three PBMs say watch out for several recently approved and expected-to-be-approved medications
Thomas Reinke
The Formulary Files
Krishna Rutvij Patel, PharmD
Medical Device Monitor
Report suggests that greater attention to cost-effectiveness, quality, and regulatory issues will force the industry to demonstrate value and be nimble
Katherine T. Adams
Tomorrow's Medicine
While both pirfenidone and nintedanib bolster lung function for this fatal disease, they do not improve survival rates
Thomas Morrow, MD