Pharmacy Benefits & Drug Pricing
Expert articles and analysis related to pharmacy benefits & drug pricing.
AI Summary — Last 7 Days
Synthesis:
This week, pharmacy benefit management and drug pricing in value-based care have been shaped by CMS’s proposed expansion of electronic prior authorization requirements for drugs under both medical and pharmacy benefits, signaling an intent to streamline administrative processes and reduce barriers to prescription drug access (HFMA summary). Meanwhile, CMS delayed the Part D implementation of the BALANCE Model—targeting GLP-1 access expansion—reflecting ongoing operational and financial tensions around integrating high-cost therapeutics into Medicare and Medicaid payment models ([AHA coverage](https://news.google.com/rss/articles/CBMiqwFBVV95cUxOaWZ0U213aUU2QUpaYl9SdVNkWnNvQmpLbWo1SnlybXhKRzNEMjlobEdNRVJjVGdQWXFOUWdLcjBOSk1XdzU0ODc1THVQMEg3Z1RhcWxSNXpIcjZHU1lUX20xYlFzNXNsS0d0VGhHUF9sdDhGNFhqOHJQTVVoWHdUc1ppRlZCeFVRaVRoSlhxb1RFWmpHNXk4LUtUT1RMdXNqVnpxQU05LU1sRms?
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