Cancer Drug Use and Spending to Rise Sharply by 2013

What are the implications of increased drug use and spending? In a recent report by Medco, while the overall drug trend in 2010 remained low at 3.7%, the costs for specialty drugs “accounted for 16.3% of plan costs but was responsible for a remarkable 70.1% of drug trend” with diabetes contributing the most to those … Continue reading

Unseen costs of prior authorization

Prior authorizations are often used as a cost containment tactic by payers — and it works in reducing the amount that the payer must pay for the PA drug (i.e. in financial terms, the line item goes down). However, decreases in the line item are showing up somewhere else. At a study conducted at the … Continue reading

Patients and doctors not the only ones hurt by prior authorizations

Apparently prior authorizations may not just be hurting physicians and denying physician-recommended treatment to their patients. A blog posted by the Redheaded Pharmacist (a retail pharmacist who is redheaded) pointed out that prior authorizations are causing retail pharmacists to spend more time and do more paperwork for prior authorizations and that the PA’s were for … Continue reading

The true costs of prior authorizations

At a recent meeting, I was just pondering whether prior authorizations really save insurance companies money. As defined by MedicineNet.com, “prior authorizations” are a cost-containment procedure that requires a prescriber to obtain permission to prescibe a medication prior to prescribing it” [my emphasis]. Insurance practices, like prior authorizations, clearly cost physicians money in terms of the amount … Continue reading