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Suzanne Tschida, PharmD, Discusses Benefit Design in Specialty Pharmacy Management
Suzanne Tschida, PharmD, vice president, specialty benefits & outcomes, OptumRx, said that at UnitedHealth Group a tiering system is used for the management of specialty medications with a cost-share or copay structure.
Suzanne Tschida, PharmD, vice president, specialty benefits & outcomes, OptumRx, said that at UnitedHealth Group a tiering system is used for the management of specialty medications with a cost-share or copay structure. Since specialty medications tend to have a higher cost-share, Dr Tschida said utilization programs are put in place to help patients stay adherent. ”That’s where we take the approach of appropriate benefit design along with making sure they have appropriate formulary strategies and utilization management programs in place to incent the member to be adherent to their therapy,” said Tschida. Prior authorization, step therapy tiering, and other utilization management programs are all important tools in improving specialty medication adherence as well as lowering costs.
Could On-Body Delivery of Isatuximab Bring More Competition to Anti-CD38 Myeloma Treatment?
June 6th 2025Results for IRAKLIA show noninferiority for Sanofi's on-body delivery system for isatuximab, compared with IV administration. Patients overwhelmingly preferred the hands-free delivery option.
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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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Zanubrutinib Shows Durable Benefit for High-Risk CLL/SLL at 5 Years in SEQUOIA Trial
June 6th 2025Zanubrutinib showed long-term efficacy in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) and deletion of the 17p chromosome, with progression-free survival similar to patients without high-risk disease characteristics.
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