Insurance and Benefit Design: Commercial provides insights on the evolution of benefit designs in the commercial health plan channel, supporting timely, effective responses to emerging access opportunities and risks for brands.
What are the current and emerging trends in commercial plan benefit designs and drug management?
What tools are commercial plans using to control access and costs?
What are the trends in commercial plan benefit designs and management of drugs with coverage on the medical benefit?
Use Insurance and Benefit Design: Commercial to:
- Stay up-to-date on benefit design and pharmacy management trends, and anticipate emerging changes
- Educate account teams and internal colleagues on changes that affect access
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Coverage Landscape February
- Overview of medical and pharmacy coverage in the United States
- Assessment of key payers across channels
- Analysis of key trends in market
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Pharmacy Management Trends May
- Benefit design trends, including tiering, cost sharing, deductibles, and premiums
- Use of enhanced and restrictive formularies
- Utilization management tool use
- Management of biosimilars
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Medical Benefit Management Trends August
- Medical benefit management and tactics
- Trends in specialty pharmacy use, buy-and-bill approval rates, preferred distribution channels, and site-of-care selection
- Impact of biosimilar access
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Patient Affordability and Assistance November
- Assessment of regulations/management of patient assistance programs
- Copay assistance use
- Accumulator/maximizer use
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Market Alerts
Timely analysis of payer reactions to significant market events, including:
- FDA approvals or rejections of new products
- Market entry of branded or generic drugs
- Expansion of treatment guidelines or recommendations
- Release of high-profile head-to-head trial data