As health care moves toward a value-based payment model, the pharmacy benefit is going in the opposite direction, one that places unit cost over clinical appropriateness. Have you ever used your drug ...

Drug Formularies What’s Covered vs. What’s Not How to Get Drugs Approved by Insurance Coverage for Biosimilars When Prescribed Drugs Aren’t Covered When it comes to your medication, it’s important to ...

Covered drugs are arranged by cost in tiers or levels. Generics are in the lowest tiers and are generally the lowest cost. Coverage and drug lists vary from plan to plan. Plans can change covered ...

The author suggests three ways Congress should act to make life-altering medications affordable for Americans.

Starting Jan. 1, 2025, millions of Americans who get their prescription drugs through Medicare could get a major financial break when a $2,000 out-of-pocket spending cap on medications goes into ...

Insurance companies don't cover some medications, which often leaves consumers responsible for the full costs. If your prescription is not covered, you can try generics, biosimilars, or other ...

A large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions. Objectives: A large ...

MedVantx, Inc., a leading provider of point-of-care medication access, adherence and direct-to-patient consumer engagement programs, today announced the Company's MedStart Formulary Connect™ program.

Question: My part D plan doesn’t cover one of my medications. Can I just pay for it with cash? Answer: I often have individuals tell me this time of year that next year one of their medications are ...

Are Weight Loss Drugs Covered By Insurance? This article was reviewed by Craig Primack, MD, FACP, FAAP, FOMA. If you’re considering using medication to reach a healthy body weight, your first question ...