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Pharmacy benefit managers (PBMs) are in the crosshairs of Republicans and Democrats in Congress but have so far dodged any new litigation or reforms that had been targeted for inclusion in last ...
PBMs have recently been subject to scrutiny mainly due to their lack of transparency regarding their complex drug pricing strategies and multiple facets of their business practices that contribute to rising drug pricing. [46] In 1998, PBMs were under investigation by Assistant U.S. Attorney James Sheehan of the federal Justice Department, and ...
Patient-reported outcomes are important in a regulatory context. The US Food and Drug Administration (FDA) has issued formal Guidance to Industry on PROs in label claims [24] and the European Medicines Agency (EMA) has produced a reflection paper on HRQoL. [25] Increasing numbers of regulatory submissions for new drugs provide PRO data to ...
Prescription drug monitoring programs, or PDMPs, are an example of one initiative proposed to alleviate effects of the opioid crisis. [1] The programs are designed to restrict prescription drug abuse by limiting a patient's ability to obtain similar prescriptions from multiple providers (i.e. “doctor shopping”) and reducing diversion of controlled substances.
Pharmacy benefits managers (PBMs) are employing new strategies to squeeze independent pharmacies, even as the industry faces pressure from the federal government, which is looking for ways to curb ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
b. Developing guidelines (standards) for appropriate drug use c. Assess the effectiveness of medication d. Enhance accountability in drug use e. Control medical expenses f. Prevention of drug-related problems such as adverse drug reactions, treatment failure, overuse, under-use, incorrect dosage and use of over-the-counter drugs g.
The Pharmaceutical Care Management Association (PCMA) is an American national trade association representing pharmacy benefit managers.According to the association's mission statement, PCMA advocates on behalf of its member companies, which claim to improve affordability of prescription drugs and quality of care through the use of tools such as electronic prescribing (e-prescribing), [1 ...