How Payers Confront Racial and Ethnic Disparities
The Statue of Liberty has welcomed generations of immigrants to the United States — its torch a symbol of enlightenment.
The Statue of Liberty has welcomed generations of immigrants to the United States — its torch a symbol of enlightenment.
Superheroes like Batman, Spiderman, Captain America, and Black Panther wear masks, and their brave acts reduce social costs. When these
The official motto of the United States of America can be found on our currency and coins: “In God we
Way back, surveyors chiseled marks in stone structures to serve as a “bench” for a leveling rod, ensuring consistent measurement.
Everyone negatively impacted by gun violence hopes it is the shot heard around the world. Yet in the United States,
Perhaps you’ve noticed that a standard deck of playing cards has 52 cards, just as there are 52 weeks in
Paint-by-number kits assign colors to specific areas to reproduce art, including great works like Leonardo da Vinci’s The Last Supper
In these dark and uncertain times, we seek light and predictability — even if that means a new normal. The
Someone once said something like, “When one door closes, another opens; but we often look so long and so regretfully
Do you believe in love at first sight — like the instant head-over-heels connection between Cinderella and Prince Charming in
Sometimes you have to take a step back to see the big picture — the forest for the trees. Sometimes
During the holiday season when gifts are often exchanged, one might recall the old proverb: Don’t look a gift horse
If you’ve experienced the joy of attending the Macy’s Thanksgiving Day Parade, you know that the balloons are huge. The
Life hacks are those simple, clever methods that boost productivity or efficiency. While the term life hack was coined in
Cherry Coke is sweet, but cherry picking a comparator to maximize the contrast effect can leave a sour taste in
Population health is on fire and, importantly, makes sense. And though the term is somewhat new (popularized by the Triple
A level playing field helps to ensure a fair contest between two teams — it wouldn’t be fair if one
Fads, crazes, hits, and styles come and go. Looking back, the popular diet, toy, song, or haircut now seems silly.
Why pay taxes? Likely to avoid the potential consequences of tax evasion. Why slow down after spotting a police car?
Imagine a world without standards. There would be disagreements about everything. There would be no shared understanding of time and
You’re probably familiar with the mnemonic “I before E, except after C” which couples both a spelling rule and an
Many policymakers think there is a drug rebate crisis, and consultants who should know better have led them astray by
Sherpa guides have led explorers through the Himalayas for many years. In such challenging conditions, an effective guide is knowledgeable,
Winning a game of Monopoly — assuming players have the stamina to play to the end — depends on some
Invariably, you’ve questioned the fit of two or more things in countless situations — when working on a puzzle, trying
The light bulb has become a symbol of innovation for good reason. Thomas Edison, the inventor and a cofounder of
Criticism of rebates between sellers and buyers is not new. For example, Standard Oil received rebates from railroads beginning in
There is growing scrutiny about the spend and trend of prescription drugs and the role PBMs play in it. Many
Life and work are full of decisions — many small decisions and a few big decisions. One of the big
The near-monopolistic control the De Beers corporation exercises is the primary reason diamonds cost so much. Diamonds are not rare,
Benjamin Franklin said nothing in this world except death and taxes is certain. Of course, there are other some other absolutes,
You know the old saying, “An apple a day keeps the doctor away”? Or how about the idiom “An ounce
The Magilla Gorilla Show’s theme song chanted that “at any price, a gorilla like Magilla is mighty nice.” And MasterCard’s “Priceless” campaign
The spiritual “Dem Dry Bones” with catchy lines like “Hip bone connected to the back bone” provides an overly simplistic
Organizations often make plans for the New Year, and reflections on the past year are typically part of this process.
Perhaps you remember the “But wait! There’s more!” line from the Ginsu knife ads. Or maybe you recall anxiously searching
Value-based contracts between payers and manufacturers are in vogue. From the payer’s perspective, paying for performance by getting reimbursed for
The Marshmallow Test — giving a young child a choice between eating one marshmallow now or getting two marshmallows if
Manufacturers can bring truly innovative drugs and medtech to market. But to health systems, it’s not just what manufacturers do
Some people dislike or even fear tight spaces, like crowded elevators. But for payers, there are several reasons to love
Off-label use of drugs and medical devices is legal and very common. Once a manufacturer has demonstrated to the FDA
Though all the king’s horses and all the king’s men couldn’t put Humpty Dumpty together again, it’s pretty easy to
Manufacturers and payers are guilty of making quick fixes that address a symptom but not the underlying problem. Sure, these
In the dance between manufacturers and payers, brands that initially achieve commercial success often become more successful. There is a
Cancer drugs: New products and uses and guidelines — oh my! Payers historically have avoided aggressive utilization management of cancer
Payers’ use of prior authorization (PA) is often discussed but seldom fully understood. Myths and misconceptions related to PAs abound
Here’s a bumper sticker: Honk if you know what your customer really wants. For a manufacturer, successful payer marketing hinges
Measurement is commonly linked with good management. You may be familiar with the old saw in carpentry measure twice, cut
Yes, sometimes payers view “non-inferior” products as being superior. Just how they react to new products with evidence of non-inferiority
While P&T committee meetings are typically serious and professional, like all social situations, funny things can happen. Pharmacy and medical
A mock pharmacy and therapeutics (P&T) or health technology assessment (HTA) committee meeting is one of several methods manufacturers can
An observer may ask whether a difference is significant. This seemingly simple question requires a nuanced answer, because there is
Convenience products are those that are relatively easier to use than alternatives already on the market. Products that require less
Change in health care is constant, and with that change payers expect new stuff — new products, services, evidence, guidelines,
Value. It is always wanted, commonly discussed, occasionally conceptualized, yet infrequently operationalized or measured correctly. But if optimizing value is
Payers often conduct a budget impact analysis to assess the affordability of a new offering, such as a drug, medical
Real-World Decisions In essence, payers make formulary management/medical policy decisions based on three criteria: efficacy, safety and cost. When a
Are Payers Just Not That Into Your Brand? You’re trying to optimize market access for your brand, yet you have