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Express Scripts Wants Early Discussions to Help Lower Treatment Costs
After their decision to include Abbvie's triple combination for hepatitis C on their formulary, over Gilead's more expensive regimens, Express Scripts indicated at the J. P. Morgan Healthcare Conference that they'll continue the stance of choosing treatments that are equally effective but save costs, especially in cancer.
Express Scripts, the largest U.S. pharmacy benefit manager, on Tuesday said cost savings on expensive cancer treatments could be achieved if the company were involved earlier in the decision-making process.
Express Scripts, which has become more aggressive in negotiating discounts on drugs for insurance plans and employers, in December stopped covering Gilead Sciences Inc's hepatitis C treatments after lining up a cheaper price for AbbVie's newly-approved alternative.
Gilead's Sovaldi and follow-up combination pill Harvoni have been shown to cure hepatitis C in more than 90 percent of patients. But Express deemed the more than $90,000 price for 12 weeks of Harvoni treatment unaffordable.
The move reignited investor concerns that drugmakers will have to bow to pricing pressure from U.S. insurers and lawmakers over novel medications whose cost can reach hundreds of thousands of dollars for some diseases.
Read the complete report on Reuters: http://reut.rs/1wc6Bnv
Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays
June 19th 2025Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.
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Culture Key to Data Collection of Sexual Orientation and Gender Identity in Cancer Care
June 23rd 2025This research highlights the key factors, like leadership buy-in, mandatory protocols, and electronic health record workflows, that influence the effective collection of data on sexual orientation and gender identity in outpatient oncology clinics to improve patient-centered care.
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