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DATE 2017-06-01

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MESSAGE
DATE 2017-06-11
FROM Ruben Safir
SUBJECT Re: [Hangout - NYLXS] Time to end the kickbacks and the control
From hangout-bounces-at-nylxs.com Sun Jun 11 03:01:14 2017
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From: Ruben Safir
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https://aishealthdata.com/news/health-plans-pbms-embrace-drug-exclusions-ne=
w-formulary-offerings

Health Plans, PBMs Embrace Drug Exclusions With New Formulary Offerings

Aggressive formulary management will continue to play a key role in
containing pharmaceutical costs, especially those related to specialty
products, in 2015. No better example exists than the rise of formulary
exclusions, or the concept of blocking from coverage select brand-name
drugs rather than relegating them to higher cost tiers, in order to
achieve better manufacturer discounts.

CVS Caremark Corp. and Express Scripts Holding Co. have both grown their
exclusion lists for 2015, while Catamaran Corp. in mid-2014 launched its
optional Value Formulary that does not exclude any specialty drugs. And
despite public debate about member disruption and the potential impact
of exclusions on pharmacy trend and greater medical spend, more payers
and PBMs are going ahead with exclusionary strategies for 2015.

=E2=80=9CAt this point, most of my clients are grudgingly accepting the =E2=
=80=98new
world order=E2=80=99 of exclusion-based formularies,=E2=80=9D Josh Golden, =
practice
leader, employer consulting, at Pharmaceutical Strategies Group LLC,
tells AIS. =E2=80=9CAnd while specialty drug classes used to be off limits =
for
aggressive formulary management, that old rule really no longer applies
for a number of specialty disease states.=E2=80=9D

Craig Oberg, R.Ph., managing consultant at The Burchfield Group,
estimates that about two-thirds of clients have adopted formulary
exclusions for 2015. =E2=80=9CThe savings generated through exclusions is l=
ess
about reductions in ingredient cost and more about preserving
manufacturer rebates,=E2=80=9D he observes.=E2=80=9D The number of opportun=
ities to
exclude products has and will continue to decline with each successive
year. The use of exclusions as a cost management [tool] for traditional
medications will lose importance in the future. The opportunities for
exclusions in the area of specialty medications will be limited due to
the necessity of having a minimum of two products that can deliver
nearly identical clinical results.=E2=80=9D

=E2=80=9CThere=E2=80=99s no doubt that the PBMs=E2=80=99 specialty formular=
y maneuvers are
driving significant manufacturer incentives behind the scenes,=E2=80=9D adds
Golden. =E2=80=9CThe crucial question is whether those incentives flow back=
to
the plan sponsor, or get pocketed by the PBM. And the answer to that
question depends on the client=E2=80=99s contract terms.=E2=80=9D

Here are a few of the exclusionary options new to the marketplace for 2015:

Prime Therapeutics LLC, which has not =E2=80=9Cadvocated heavily=E2=80=
=9D for
formulary exclusions in the past, in late 2014 introduced three options
for its Blue Cross and Blue Shield plan owners and clients as well as
self-insured employer groups. The first is a basic option that
identifies four categories for utilization management without
grandfathering and offers the lowest amount of cost reduction at 75
cents per prescription; the other two are =E2=80=9Ctrue exclusion options=
=E2=80=9D and
can result in net savings to the plan of up to $1.15 per prescription
(generics-focused option) or up to $2.80 per prescription (enhanced).

Independent Health in 2014 moved from an open to a closed three-tier
formulary design and will increase the number of drugs that are
non-formulary, including multi-source brand drugs, for 2015. Martin
Burruano, R.Ph., vice president for pharmacy at the Western New York
insurer, which operates its own PBM, explains this change was partly in
response to =E2=80=9Cmanufacturer coupons=E2=80=A6negating the positive eff=
ects of a
tiered formulary design.=E2=80=9D Moreover, the insurer has moved high-cost
generics into higher tiers across multiple therapeutic categories. =E2=80=
=9CFor
the drugs that are excluded, formulary alternatives are available,=E2=80=9D=
he
adds. The savings associated with these changes are expected to result
in an approximate 3% decrease in overall drug spend.
Envision Pharmaceutical Services (EnvisionRxOptions) in late 2014
unveiled the Performance Formulary, in which clients must =E2=80=9Copt in=
=E2=80=9D to
use the drug list that =E2=80=9Cintegrates formulary exclusion logic with s=
tep
therapy.=E2=80=9D The formulary features 10 step therapies and 11 exclusion=
s;
categories subject to exclusion are acne, diabetes testing supplies,
insulins, injectable diabetes medications, overactive bladder
medications and androgens. Envision estimates that clients can achieve
an additional 5% to 10% in savings, while expected member disruption is
typically less than 1.5% of utilizing members.

In addition to existing formulary options that exclude drugs used
for cosmetic purposes, weight loss, erectile dysfunction, and smoking
cessation, Navitus Health Solutions, LLC=E2=80=99s new SelectPlus Formulary
further excludes approximately 45 agents in categories and classes
deemed therapeutically interchangeable by the Navitus Pharmacy and
Therapeutics Committee. These include topical testosterone, nasal
steroids, long-acting opioids, diabetic test strips and insulin; some
specialty agents are also subject to exclusions. Navitus anticipates
savings anywhere from 6% to 10% with the new formulary product, which is
offered on an opt-in basis.

Contact Burruano via Frank Sava at frank.sava-at-independenthealth.com,
EnvisionRx spokesperson Josh Paulen at jpaulen-at-rxoptions.net, Golden at
jgolden-at-psgconsults.com, Navitus spokesperson Chantel Soumis at
chantel.soumis-at-navitus.com, Oberg via Christine Hanson-Ehlinger at
chanson-ehlinger-at-burchfieldgroup.com and Prime spokesperson Laura Aumann
at laumann-at-primetherapeutics.com.
Excerpted from the 1/9/2015 issue of AIS=E2=80=99s Drug Benefit News

-- =

So many immigrant groups have swept through our town
that Brooklyn, like Atlantis, reaches mythological
proportions in the mind of the world - RI Safir 1998
http://www.mrbrklyn.com

DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://www.nylxs.com - Leadership Development in Free Software
http://www2.mrbrklyn.com/resources - Unpublished Archive
http://www.coinhangout.com - coins!
http://www.brooklyn-living.com

Being so tracked is for FARM ANIMALS and and extermination camps,
but incompatible with living as a free human being. -RI Safir 2013
_______________________________________________
Hangout mailing list
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  32. 2017-06-07 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] London lowdown
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  53. 2017-06-09 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] [Hangout of NYLXS] : Debian derivative that
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  59. 2017-06-09 Rick Moen <rick-at-linuxmafia.com> Re: [Hangout - NYLXS] Abbott Scam
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  68. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Abbott Scam
  69. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Abbott Scam
  70. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Abbott Scam
  71. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Abbott Scam
  72. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Abbott Scam - tightening the nose on the
  73. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  74. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  75. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  76. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  77. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  78. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] PBMs and Rebates... lets not just blame Abbott
  79. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] Abbotts lies in its markets
  80. 2017-06-11 Rick Moen <rick-at-linuxmafia.com> Re: [Hangout - NYLXS] Abbott Scam
  81. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] Time to end the kickbacks and the control
  82. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Re: [Hangout - NYLXS] Time to end the kickbacks and the control
  83. 2017-06-11 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] Abbott Scam
  84. 2017-06-11 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] Abbott Scam
  85. 2017-06-11 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Fwd: Re: mod_perl and cgi-script handler
  86. 2017-06-11 From: "Ruben.Safir" <ruben.safir-at-my.liu.edu> Subject: [Hangout - NYLXS] Language Workshops
  87. 2017-06-11 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Suplementry IT training
  88. 2017-06-11 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] we'll always have Paris
  89. 2017-06-12 From: "Mancini, Sabin (DFS)" <Sabin.Mancini-at-dfs.ny.gov> Re: [Hangout - NYLXS] Abbott Scam: Wow. Ruben is pretty hot on this
  90. 2017-06-11 Gabor Szabo <gabor-at-szabgab.com> Subject: [Hangout - NYLXS] [Perlweekly] #307 - The Perl Conference is nearly
  91. 2017-06-12 From: "APhA's Pharmacy Today" <PTdaily-at-aphanet.org> Subject: [Hangout - NYLXS] =?utf-8?q?June_12=2C_2017=3A_Opioid_Crisis_Comp?=
  92. 2017-06-12 From: "soledad.esteban" <soledad.esteban-at-icp.cat> Subject: [Hangout - NYLXS] [dinosaur] International course on Scientific
  93. 2017-06-13 From: "Chaim Desser" <career-at-poelgroup.com> Subject: [Hangout - NYLXS] position to review
  94. 2017-06-13 James E Keenan <jkeenan-at-pobox.com> Subject: [Hangout - NYLXS] TPC here and there
  95. 2017-06-14 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] busy today with corruption on linkedin
  96. 2017-06-15 From: "Yi Qian, IEEE ICC'18 TPC Chair" <noreply-at-comsoc.org> Subject: [Hangout - NYLXS] IEEE ICC'18 Call for Workshop Proposals &
  97. 2017-06-17 ruth02-at-web.de Re: [Hangout - NYLXS] [Hangout of NYLXS] - Guarantee- I am not in
  98. 2017-06-19 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] MTA extortion
  99. 2017-06-19 Mark Halegua <phantom21-at-mindspring.com> Re: [Hangout - NYLXS] MTA extortion
  100. 2017-06-19 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Jobs
  101. 2017-06-20 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Jobs
  102. 2017-06-20 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Movie of the Week
  103. 2017-06-23 Kevin Zheng <kevinz5000-at-gmail.com> Subject: [Hangout - NYLXS] [crossfire] Release proposal
  104. 2017-06-23 Mark Wedel <mwedel-at-sonic.net> Re: [Hangout - NYLXS] [crossfire] Release proposal
  105. 2017-06-23 Rick Tanner <leaf-at-real-time.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  106. 2017-06-23 Kevin Zheng <kevinz5000-at-gmail.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  107. 2017-06-23 Kevin Zheng <kevinz5000-at-gmail.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  108. 2017-06-23 Matthew Giassa <matthew-at-giassa.net> Re: [Hangout - NYLXS] [crossfire] Release proposal
  109. 2017-06-23 Preston Crow <pc-crossfire06-at-crowcastle.net> Subject: [Hangout - NYLXS] [crossfire] Crossfire maps idea
  110. 2017-06-23 David Hurst <davidnicholashurst-at-gmail.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  111. 2017-06-23 Rick Tanner <leaf-at-real-time.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  112. 2017-06-23 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  113. 2017-06-23 From: "Meaningful Beauty" <MeaningfulBeauty-at-islerpatto.stream> Subject: [Hangout - NYLXS] Youthful looking Skin + Free-Shipping
  114. 2017-06-23 David Hurst <davidnicholashurst-at-gmail.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  115. 2017-06-25 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] TED on the threat of AI in the Military
  116. 2017-06-26 Gabor Szabo <gabor-at-szabgab.com> Subject: [Hangout - NYLXS] [Perlweekly] #309 - csvgrep and the recipe for
  117. 2017-06-26 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Fishing images
  118. 2017-06-26 opensuse-security-at-opensuse.org Subject: [Hangout - NYLXS] [security-announce] SUSE-SU-2017:1669-1:
  119. 2017-06-26 opensuse-security-at-opensuse.org Subject: [Hangout - NYLXS] [security-announce] openSUSE-SU-2017:1685-1:
  120. 2017-06-26 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] Fishing images
  121. 2017-06-26 Rick Tanner <leaf-at-real-time.com> Re: [Hangout - NYLXS] [crossfire] Release proposal
  122. 2017-06-26 Rick Tanner <leaf-at-real-time.com> Subject: [Hangout - NYLXS] [crossfire] Expanded World Map (was: Release
  123. 2017-06-26 Rick Tanner <leaf-at-real-time.com> Re: [Hangout - NYLXS] [crossfire] Crossfire maps idea
  124. 2017-06-27 From: "S." <sman356-at-yahoo.com> Subject: [Hangout - NYLXS] Score: 9 - 0 ! WIN ! on SCOTUS
  125. 2017-06-23 From: "NYU Langone Careers" <nyumccareers-at-symphonytalent.com> Subject: [Hangout - NYLXS] Follow up from NYU Langone Medical Center
  126. 2017-06-28 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] family in need
  127. 2017-06-28 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] A train derailment
  128. 2017-06-28 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] A train derailment
  129. 2017-06-28 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Must See website
  130. 2017-06-28 Ruben Safir <ruben-at-mrbrklyn.com> Re: [Hangout - NYLXS] A train derailment
  131. 2017-06-28 Ruben Safir <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] Fwd: [manjaro-general] Manjaro-Architect ISO
  132. 2017-06-29 ruben <ruben-at-mrbrklyn.com> Subject: [Hangout - NYLXS] time to put down the phone
  133. 2017-06-29 From: "Mancini, Sabin (DFS)" <Sabin.Mancini-at-dfs.ny.gov> Re: [Hangout - NYLXS] Lottery programmer rigs systems in 4 states,
  134. 2017-06-30 Ruben Safir <mrbrklyn-at-panix.com> Subject: [Hangout - NYLXS] Dinosaur found in Amber

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