Value-Based Contracting in 2021
Todd Edgar shares new perspectives on value-based contracting on how these contracts should be viewed, learnings from past years, and opportunities to make them a win-win for stakeholders.
What Does 2021 Look Like for PBMs?
While campaigning, President-elect Biden laid out many proposals with respect to healthcare, most of which have in common the effect of expanding the Federal government’s role in this space. Todd Edgar explores how this expanded role will affect managing healthcare, and the effect it will have on PBMs.
2021 PBM Commercial Formulary Exclusions Are Here to Stay Even With COVID-19
The trend in the approach to formulary management is to become more restrictive every year. This year is an exception, with some industry restrictions loosening in response to the COVID-19 pandemic. As the formulary development process for 2021 begins, Todd Edgar discusses whether the historical trend will continue or if there will be more efforts to loosen restrictions.
The Dog That Didn’t Bite—or Market Events of 2019
The most important events in healthcare in 2019 were the ones that didn’t happen. Access Experience Team member Todd Edgar explains why, with a focus on drug pricing and policy proposals.
PBM Formulary Predictions: A Look Ahead
Rebate sharing, exclusion lists, and application of QALY measures are all approaches that PBMs are likely to ramp up in 2020, predicts Todd Edgar. Todd examines the impact of new formulary guidelines and makes some predictions on other trends likely in the coming year.
Rebate Safe Harbor Proposal Evolution
With the Trump Administration’s recent withdrawal of their proposal to modify the rebate safe harbor, what do manufacturers need to know in preparing for the future? Todd Edgar reviews the history of the proposal and offers some advice.
Questions Unanswered in HHS Safe Harbor Proposal
With the release of the HHS safe harbor proposal, more information is available than when only the title was public. Indeed, over the past few weeks, many articles have been published with detailed summaries of the proposal—yet, many questions remain. For All Access, Todd Edgar breaks down some of the most granular issues to consider and asks the question: How prepared is the market for a change of this magnitude?
Removal of Pharmaceutical Rebate Safe Harbor: Rough Waters Ahead?
The current administration is considering removing the safe harbor protection used to prevent drug rebates from being considered a kickback. While the details are still developing, such a move would likely have significant impacts on PBMs, manufacturers, and patients. Todd Edgar explores the possible ramifications.
Solving the Conflicts in Quality-Based Care
Todd Edgar, Senior Vice President, Payer Access Solutions, outlines multistakeholder perspectives of quality-based care and how these can be in conflict. Todd discusses potential solutions to bring views into alignment, with the goal of improving quality-driven care within the system.