Examples of formulary exclusions (removals) and updates
Formularies and PBMS
What Is a Formulary? In its simplest form, a formulary is a list A drug formulary is a preferred drug list. The list of medications on the formulary changes based…
How do Pharmacy Benefit Managers Determine Pricing?
This is a complex subject—first, some introductory concepts. Then, the details. In healthcare, the intersection of demand, price, quality, and suppliers' sources alone does not determine whether pricing is appropriate.[i]…
Pharmacy Benefit Managers Drug Pricing and Appeals
Pharmacy Benefit Manager Drug Pricing and MAC Appeals - PBM MAC Appeals Pharmacy Benefit Managers drug pricing uses several metrics and Standards. Pharmacy Benefit Managers (PBMs) may use Maximum Allowable…
Pharmacy Benefit Managers - U.S. Pharmacy Distribution and Reimbursement System
Pharmacy Benefit Manager Expert Witness
Pharmacy Benefit Manager Expert Witness A Pharmacy Benefit Managers expert witness (also known as PBM expert witness) must comprehend that Drug Prices are complex. First, I'm introducing some introductory concepts.…