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Latest From Aetna Inc.

PBM Formulary Exclusions In Oncology Are On The Rise

Oncology drugs are no longer immune to pharmacy benefit management formulary exclusions in the commercial market and even drugs administered in a physician’s office are increasingly being subjected to rebate-driven coverage decisions.

Reimbursement Pricing Strategies

The Rebate Rule May Not Last, But It Changed The Pricing Debate

Trump Administration’s attempt to eliminate rebates in the US Medicare outpatient drug benefit program is the easiest and most certain item among the 11th hour pricing policy changes for the incoming Biden Administration to undo. But it still had a major impact on the dynamics of the drug pricing debate.

Pricing Debate Medicare

Why Value-Based Health Care Is Here To Stay

COVID-19 has disrupted the operational schedules of health care and technology providers alike to unparalleled levels in 2020. But scratch the surface, and outcomes-oriented, value-based health care targets remains a priority – albeit competing a little harder for attention at present.

Business Strategies Commercial

Expanded Access Advocates Seek Reimbursement Mandate, Manufacturer Incentives From Congress

Next round of biomedical innovation legislation provides opportunity to require insurance reimbursement of investigational drugs and related medical services, as well as new incentives for small biotech companies to offer expanded access programs, stakeholders say.

Legislation Reimbursement
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