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Neil Minkoff, MD, Explains the Impact Formulary Has on Employer and Consumer Choice in the Health Insurance Exchanges
Neil Minkoff, MD, CEO, FountainHead HealthCare, discusses the impact that formulary has on both employer and consumer choice in the health insurance exchanges.
Neil Minkoff, MD, CEO, FountainHead HealthCare, discusses the impact that formulary has on both employer and consumer choice in the health insurance exchanges. He says that the industry has reached a point where an estimated 75% to 80% of prescription drug volume is generic. However, there’s less scrutiny of pharmacy benefits in general, as that scrutiny has moved to biotech and specialty.
“The employer and the plan are in a position of needing to offer the appropriate drug to the appropriate patient because it’s become the standard of care, but not being so generous in a benefit that they suffer from adverse selection… and that’s the tight rope that both employers and plans are trying to deal with right now,” he says.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Finding the Right Biomarker Is Key to the TIGIT Puzzle, Experts Say
May 12th 2025Data for SKYSCRAPER-01, involving the anti-TIGIT antibody tiragolumab, align with recent bad news for this once-promising therapeutic target. But investigators involved in TIGIT studies say the problem is finding the right biomarker.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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