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Re-evaluating Value in Health Plan Management (PDF)
Chelko Consulting Group Link to more items from this source
[Opinion]
Aug. 28, 2015
"One [pharmacy benefit manager] recently estimated plan sponsors are wasting $4.9 billion annually as a result of inadequate management of specialty medications in the medical benefit. Most of this waste could be avoided by applying the utilization and trend-management programs that are traditionally found in the pharmacy benefit to the medical benefit.... [T]he results of [these] efforts will be more limited unless they are coupled with a new resolve regarding something most benefit managers have not considered: namely, providing different levels of plan coverage for the same specialty drug when it is used for different conditions."

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