Utilization Management
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340B, Affordable Care Act, Biosimilars, Caught my eye, Drug Prices, Inflation Reduction Act, Insulin, Medicare Negotiation, Medicare Part D, Pharmacy Benefit Managers, State-based Reform, Utilization ManagementAMP is WAC — 2/13/26
Read more: AMP is WAC — 2/13/26I chuckled during the E&C hearing when members were questioning the panelists about the pharmaceutical deals with the Administration. As if these are the people they should be asking. Make a left, make right, go down about a mile – there’s a big white house. Maybe they can help you there. Parallels Between 340B and…
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Caught my eye, Copay Accumulators, Drug Prices, Employers, Healthcare Costs, Insulin, Medicare Part D, Pharmacy Benefit Managers, Utilization ManagementAMP is WAC — 2/6/26
Read more: AMP is WAC — 2/6/26No, I do not think that a groundhog is a meteorologist. But, one year I am determined to make it to see Punxsutawney Phil. I expect it to be silly and cold and over quickly. I will likely have to go solo because my family thinks getting a bus from a Wal-mart parking lot in…
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Affordable Care Act, Caught my eye, Drug Prices, DTC, Employers, Medicare Advantage, Medicare Part D, Pharmacy Benefit Managers, Reference Pricing, State-based Reform, Utilization ManagementAMP is WAC — 1/30/26
Read more: AMP is WAC — 1/30/26This week I had to remind myself that we live in the AND. Things can be truly awful around us, but there are still moments of happiness and hope. There are some periods in life where it is harder to find the AND, but it is there. At least that is what I have to…
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340B, Affordable Care Act, Caught my eye, CMMI, Drug Prices, Healthcare Costs, ICER, Medicare Part D, Pharmacy Benefit Managers, Reference Pricing, State-based Reform, Utilization ManagementAMP is WAC — 12/19/25
Read more: AMP is WAC — 12/19/25Today we’re expecting to hear more about manufacturer Most Favored Nation (MFN) agreements and (if you trust the rumors) maybe more about the MFN demos – the Global Benchmark for Efficient Drug Pricing (GLOBE) Model and the Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model. I wasn’t planning on publishing the next two weeks,…
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Affordable Care Act, Inflation Reduction Act, Medicare Advantage, Medicare Negotiation, Medicare Part D, Obesity, Utilization ManagementBack at it
Read more: Back at itHo, Ho. Ho, Ho. It’s likely back to work you go. If you checked out the last week, here is what you might need to know before you get too far into your week. I will have the regular AMP is WAC on Friday but a catch-up felt in order. Waiting Game. The rollout of…
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Biosimilars, Caught my eye, Generics, Health Equity, ICER, Medicare Advantage, Medicare Part D, Obesity, Pharmacy Benefit Managers, State-based Reform, Utilization Management, ValueAMP is WAC — 10/31/25
Read more: AMP is WAC — 10/31/25You won’t be surprised when I tell you that my favorite Halloween costume was when I wore a pair of scrubs with vinyl records attached (Spin Doctor). Yep. Right up there with Freudian slips. This year I will stick to my usual costume: the nice lady who hands out full-size bars to 200+ neighborhood kids.…
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Affordable Care Act, Caught my eye, Employers, Healthcare Costs, Medicaid, Medicare Part D, Pharmacy Benefit Managers, Reference Pricing, State-based Reform, Utilization ManagementAMP is WAC — 9/19/25
Read more: AMP is WAC — 9/19/25Work travel is usually a nice change of pace. And then I found myself on a Wednesday afternoon on the NJ Turnpike in torrential rain with other cars facing the wrong direction. Super fun! Two good things – 1) the pharma team I gave the talk to was awesome and 2) made it home safe…
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340B, Affordable Care Act, Caught my eye, CMMI, Drug Prices, DTC, Employers, Medicare Advantage, Medicare Part D, Reference Pricing, Supply Chain, Utilization ManagementAMP is WAC — 9/12/25
Read more: AMP is WAC — 9/12/25On one hand, a busy week in the world of health policy. The quicksand of news in 2025 is real so I do my best to sidestep some news (MAHA report) to dive into the things that I think are important for my clients – including expected premium spikes, 340B rebate backlash and Medicare changes.…
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340B, Caught my eye, Drug shortages, Pharmacy Benefit Managers, Supply Chain, Utilization ManagementAMP is WAC — 7/25/25
Read more: AMP is WAC — 7/25/25Next week we’ll have our first glimpse of the Medicare Part D premiums for 2026; I expect them to be pretty awful. The Part D redesign shifted additional liability onto plans without changing enough of the premium calculation. Some articles next week will say it is unintended consequence; I think it is an intended one…
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Affordable Care Act, Biosimilars, Caught my eye, Employers, Healthcare Costs, Inflation Reduction Act, Medicare Advantage, Medicare Part D, Pharmacy Benefit Managers, Utilization ManagementAMP is WAC — 6/27/25
Read more: AMP is WAC — 6/27/25In case you think I’m opinionated, just know that it could be so.much.worse. I often write something and then hit backspace, backspace, backspace. You’re welcome? Off next week for the 4th of July. Caught my Eye Tradeoffs. Last week USC put out a paper that reviewed how many Medicare Part D beneficiaries will likely pay…
Latest news
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