Specialty
Monitoring efficacy and outcomes of high cost specialty medications can help lower costs for payors More
Briefing
“Utilization Management”
20 result(s)
Specialty
Documentation for prior authorizations to ensure clinically appropriate utilization of autoimmune therapies More
Briefing
Specialty
Enhanced Specialty Guideline Management Offers Payors Choice and Flexibility in Coverage for Acthar Gel More
Briefing
Cost Management
A Unique Focus for a PBM: Keeping Members Off Medication
Strategies for managing drug spend forpayors include helping members achieve better health and de-prescribing. More
Commentary
Cost Management
Payor strategies for specialty drug spend must strike a balance between affordability and member experience. More
Commentary
Cost Management
As part of the CVS Health hyperinflation strategy, our Outlier Pharmacy Program proactively monitors and identifies pharmacies with increased volume in claims submissions of... More
Briefing
Drug Pipeline
Effective management strategies can help payors manage cost for a range of new treatment options in the drug pipeline. Several medications are nearing approvals for Alzheimer’s,... More
Briefing
Specialty
Clinically rigorous, accredited UM, and EHR connectivity helps ensure durable denials that deliver true, lasting savings. More
Briefing
Specialty
Hear Prem Shah, Executive Vice President, CVS Health, addresses solutions for rising specialty drug costs. More
Video