STAT+: Tennessee officials find Express Scripts violated law governing commercial pharmacy claims
STAT
APRIL 13, 2025
For the moment, the state has not fined the company, although it may yet do so, according to a consent order.
How to get Dupixent: Specialty pharmacy considerations
The Checkup by Singlecare
JULY 9, 2024
This is one of the reasons why Dupixent is a specialty drug and can only be filled by a specialty pharmacy. Specialty drugs are medications used to treat complex, chronic health conditions and are only available through certain pharmacies,” said Jody A. What are specialty pharmacies?
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How much is Nucala without insurance?
The Checkup by Singlecare
AUGUST 6, 2024
Is Nucala covered by insurance? Health insurance plans may cover Nucala. However, coverage can vary based on the specific insurance provider and plan. Many insurance companies may require prior authorization , meaning your healthcare provider must confirm that Nucala is medically necessary for your treatment.
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Piloting the PQA Specialty Pharmacy Turnaround Time Quality Measure
PQA
JUNE 27, 2024
The use of specialty medicine has grown rapidly in recent decades, fueling parallel growth in the number of specialty pharmacies that serve patients who are prescribed specialty medications. Results of this work were published in the Journal of Managed Care & Specialty Pharmacy in October 2022.
How much is Forteo without insurance?
The Checkup by Singlecare
MARCH 25, 2023
Is Forteo covered by insurance? | How much does Forteo cost without insurance? | How to get Forteo without insurance Forteo is a brand-name prescription drug that helps increase bone mass in people with osteoporosis. Is Forteo covered by insurance? Some insurance plans don’t cover Forteo. They may cost less.
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How much is Rinvoq (upadacitinib) without insurance?
The Checkup by Singlecare
FEBRUARY 8, 2024
Is Rinvoq covered by insurance? | How much does Rinvoq cost without insurance? | How to get Rinvoq without insurance Rinvoq (upadacitinib) is an oral prescription medication approved by the U.S. Without insurance, a one-month supply of Rinvoq costs about $7,812. Is Rinvoq covered by insurance?
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How to save on Cosentyx
The Checkup by Singlecare
JULY 2, 2024
Currently, the average price of Cosentyx prefilled syringes without insurance or discounts is: Prefilled syringe: $8,276 for one 150 mg/ml syringe Prefilled Cosentyx 300 mg dose syringe: $8,337 for two 150 mg/ml syringes The expense of UnoReady and Sensoready auto-injectors is similar.
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J&J copay lawsuit against drug benefit firm gets green light
pharmaphorum
JANUARY 27, 2023
While SaveOnSP is the nominal target of the lawsuit, it claims to expose one of the failings in the US health insurance sector, adding fire to an increasingly heated exchange between pharma manufacturers and pharmacy benefit managers (PBMs), which have blamed each other for high medicine prices in the US.
STAT+: Pharmalittle: We’re reading about an OptumRx contract, 340B dispute resolution, and more
STAT
APRIL 22, 2024
The wholesaler expects to partially offset the impact of losing the OptumRx contracts through a combination of new customer wins and growth in its specialty pharmacy business. OptumRx is a pharmacy benefit manager that acts as an intermediary between insurers and drugmakers to negotiate the prices of prescription drugs.
Teva shares slide as it faces illegal kickback charges from US government
pharmaphorum
AUGUST 20, 2020
Teva mainly administered the scheme through its specialty pharmacy, Advanced Care Scripts (ACS) with payments amounting to around $300 million during the period, according to the complaint. During that period Teva raised the price from around $17,000 per year to over $73,000 per year, the DoJ alleges.
Is Fasenra covered by Medicare?
The Checkup by Singlecare
AUGUST 3, 2024
The exact amount you pay for Fasenra depends on factors such as where you purchase it and what your insurance covers. Insurance can significantly reduce Fasenra’s out-of-pocket expenses, but for people paying entirely out of pocket, it can cost about $7,715 for one 30 mg/mL injection. “It How much does Fasenra cost?
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NASP 2022 Reveals a Pharmacy Landscape Shifting to Specialty
Omnicell
JANUARY 10, 2023
Kristen Dowd Director, Pharmacy Management Services, Omnicell If the 2022 NASP (National Association of Specialty Pharmacy) Annual Meeting and Expo is any indication, we are approaching a time when specialty pharmacy simply becomes pharmacy – when complex, high-touch biologics become nearly as ubiquitous as their broad-spectrum counterparts.
Quality and Rare Disease Community Discuss Quality Medication Use in Rare Disease
PQA
NOVEMBER 12, 2024
Patients need assistance to manage the process, insurance, and providers. Focus first on access to specialty pharmacies and then on ongoing engagement. Specialty pharmacy is a high-touch model, but even it needs to go above and beyond for those with rare disease.
Does Blue Cross cover Humira?
The Checkup by Singlecare
OCTOBER 9, 2024
However, its effectiveness and versatility come at a cost, which leaves many people looking to their insurance provider for help. Many health insurance and Medicare Part D plans will cover Humira, including some from Blue Cross Blue Shield, but it depends on the specific plan. Here’s what you need to know.
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Specialty pharma’s next big opportunity: it’s time for patient access to adopt an open protocol
pharmaphorum
NOVEMBER 1, 2022
A similar inflection point now faces the specialty pharmaceutical industry. Along their journey, specialty pharma patients interact with a series of siloed institutions: clinics, specialty pharmacies, copay program vendors, patient assistance programs, nurses, etc.
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Mail order pharmacy: What you should know about getting Rx by mail
SingleCare
JANUARY 22, 2021
Picking up your prescriptions directly from a pharmacy can be challenging with social distancing requirements, illness, or other factors. Mail order pharmacies work through health insurance providers to deliver medications straight to your home. Get More Meds We’ll send a new Rx to your pharmacy in minutes!
Does Blue Cross Blue Shield cover Dupixent?
The Checkup by Singlecare
OCTOBER 9, 2024
Specialty drugs like Dupixent are expensive to produce, and those costs are passed to consumers paying out of pocket. Insurance typically covers Dupixent, but coverage varies by plan and reason for taking. The Blue Cross and Blue Shield Association isn’t a single insurance provider.
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How to save on Fasenra
The Checkup by Singlecare
JULY 2, 2024
However, the exact cost of prescription drugs varies based on several factors, including specialty pharmacy markup. And what a person pays out of pocket is dependent upon more factors, including insurance and their choice of pharmacy. They must also have eligible commercial insurance. Others do not.
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How to save on Rinvoq: Copay card, patient assistance & more
The Checkup by Singlecare
APRIL 30, 2024
Without insurance, the current average retail price of Rinvoq is $8,319 for 30 extended-release tablets. Insurance coverage for Rinvoq Coverage for Rinvoq varies by plan, so be sure to check with your health insurance company for details on how much you’ll be expected to pay for Rinvoq.
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Nucala savings tips
The Checkup by Singlecare
JULY 8, 2024
You can only get Nucala from a specialty pharmacy. But, the list price is the wholesale price charged to pharmacies, not to patients. If prescribed Nucala without insurance, you will likely pay the list price plus an additional amount charged by the specialty pharmacy dispensing it. According to Michael O.
Does Medicaid cover Dupixent?
The Checkup by Singlecare
NOVEMBER 6, 2024
Without insurance, Dupixent can be difficult for people to afford. Without insurance or Medicaid, Dupixent costs an average of $5,225 for 2, 2 mL pens, which is typically a 30-day supply. However, Medicaid might help cover the cost. The beneficiary also has to be 6 months to 11 years old. How much does Dupixent cost?
How to save on Dupixent
The Checkup by Singlecare
APRIL 29, 2024
Dupixent’s cost without insurance is $5,037 for two 2-milliliter (mL) syringes. You will likely get Dupixent from a specialty pharmacy. Insurance coverage for Dupixent Medicare, Medicaid, and other types of insurance may cover Dupixent, but it depends on the plan. How much does Dupixent cost?
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Over Two Dozen Posters at the 2023 PQA Annual Meeting
PQA
MARCH 30, 2023
(Matthew Wallace, PharmD, BCPS) Alprazolam Adverse Effect Incidence Compared to Other Benzodiazepines Within Veterans Health Administration (Megan Meier, PharmD, BCPS) Analysis of the clinical benefit of prescription anti-obesity medication coverage in a Medicaid population (Christine Payne, PharmD) Assessing the Value of an Embedded Care Pharmacist (..)
PQA Welcomes Five New Members
PQA
OCTOBER 5, 2022
Our members include community and specialty pharmacy organizations, pharmacists and other healthcare providers, pharmacies, health plans, pharmacy benefit managers, life sciences, technology vendors, government agencies, health information technology partners, researchers, accrediting organizations and academia.
Where can I get phentermine?
The Checkup by Singlecare
APRIL 2, 2024
You will need a prescription if you want to get phentermine, but once you get the prescription, you can usually get phentermine at your local pharmacy. Phentermine is usually covered by insurance, says Meghan Garcia-Webb, MD , who is triple board-certified in internal medicine, lifestyle medicine, and obesity medicine.
PQA Welcomes 11 New Members
PQA
MARCH 28, 2024
Our members include community and specialty pharmacy organizations, pharmacists and other healthcare providers, pharmacies, health plans, pharmacy benefit managers, life sciences, technology vendors, government agencies, health information technology partners, researchers, accrediting organizations and academia.
PQA Welcomes 11 New Members
PQA
MARCH 27, 2024
Our members include community and specialty pharmacy organizations, pharmacists and other healthcare providers, pharmacies, health plans, pharmacy benefit managers, life sciences, technology vendors, government agencies, health information technology partners, researchers, accrediting organizations and academia.
Q&A with PQA Board Chair James Kirby
PQA
APRIL 29, 2025
As a pharmacist and long-time leader in the community pharmacy space, what unique perspectives do you bring to PQAs work and medication use quality? I have worked in both the payer and provider segments, including hospital, mail, and specialty pharmacy.
Pharma á la carte – 05/04/2023
The Honest Apothecary
MAY 3, 2023
Doctors vs. Ai This is because the chatbot doesn’t have to deal with insurance companies. Adam Fein speaks at Asembia The Drug Channels guru of all things related to the pharmaceutical supply chain, Adam Fein, opines on the future of specialty pharmacy at Asembia. BECKER’S. ’ MANAGED HEALTHCARE EXECUTIVE.
Does Blue Cross Blue Shield cover Remicade?
The Checkup by Singlecare
OCTOBER 15, 2024
But its effectiveness and versatility come at a price that leaves many patients hoping for health insurance coverage. If your private insurance covers Remicade, there might be some caveats involved. Insurance providers organize covered drugs into tiers. If you have a Blue Cross Blue Shield health plan, it might cover Remicade.
Fasenra vs. Nucala: Differences, similarities & side effects
The Checkup by Singlecare
SEPTEMBER 13, 2024
Fasenra vs. Nucala: Insurance coverage and cost comparison The reality is that deciding between Fasenra and Nucala may be in the hands of your health insurance. If your insurance’s drug formulary includes one and not the other or designates a more preferred status to one of the drugs, your choice may come down to finances.
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Can you work while in Medical School? The Physician Pharmacist Do's and Don'ts
The Physician Pharmacist
DECEMBER 30, 2021
Don't get me wrong, working with patients is an extremely fulfilling part of a pharmacist's job, however when you are busy stressing about your exam schedule, the last thing you want to deal with is an unruly customer or dealing with a difficulty insurance company.
Stelara generic availability, cost, and more
The Checkup by Singlecare
SEPTEMBER 10, 2024
Because Stelara is expensive without insurance, averaging $37,052 per syringe, you may want to know if there is a generic available that can help save money. It is approved by the Food and Drug Administration (FDA) to treat plaque psoriasis , psoriatic arthritis , Crohn’s disease , and ulcerative colitis.
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The “Amazon Effect” – Pharmacies, Healthcare, and Disruption
Fuld
JULY 27, 2021
These will include primary care, laboratory testing services, X-rays, and dental, eye, and ear care, as well as health insurance. Taken together, these are radical departures from the traditional retail pharmacy model. It has announced plans to install 4,000 primary care “supercenters” in its stores by 2029.
Assessing physician practices and expectations in the post-COVID era
pharmaphorum
JANUARY 22, 2021
Given the specialised focus in the analysis and the nature of the data, there are caveats associated with using this data source; these may include under-representation of in-patient claims, limited coverage of certain mail-order channels and specialty pharmacies, and the uncertainty of claims capturing for some patient populations.
Stelara for psoriasis: Dosage, efficacy & more
The Checkup by Singlecare
APRIL 16, 2024
This price does not include additional pharmacy charges, so the total depends on the pharmacy. You will likely need to get this prescription medication from a specialty pharmacy. Insurance can help you save on your Stelara cost. Contact the manufacturer for more details and eligibility requirements.
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Avsola vs. Remicade: Differences, similarities & side effects
The Checkup by Singlecare
AUGUST 6, 2024
Avsola vs. Remicade: Insurance coverage and cost comparison Avsola and Remicade are typically billed through medical insurance or Medicare Part B as a medical cost by the location where you get the infusion, such as a healthcare provider’s office, infusion center, or hospital. Varies Varies Typically covered by Medicare Part D?
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Cyltezo vs. Humira: Differences, similarities & side effects
The Checkup by Singlecare
JUNE 7, 2024
So, if a prescription is issued for Humira, the pharmacy can automatically dispense Cyltezo or another interchangeable biosimilar as allowed by individual state laws. Cyltezo vs. Humira: Insurance coverage and cost comparison Cyltezo and Humira are specialty drugs, which means you will get them from a specialty pharmacy.
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PQA Welcomes 7 New Members
PQA
MAY 13, 2025
Our members include community and specialty pharmacy organizations, pharmacists and other healthcare providers, pharmacies, health plans, pharmacy benefit managers, life sciences, technology vendors, government agencies, health information technology partners, researchers, accrediting organizations and academia.
Five for Friday February 28: Celebrating Success in Advancing Medication Use Quality
PQA
FEBRUARY 28, 2025
-- Melanie Lam, PharmD, Executive Fellow Addressing Rare Disease Pharmacy Management Asession hosted byURACat the 2024 NASP Annual Meeting & Expodiscussedthe unique natureand opportunitiesof rare disease pharmacy management, and how different health systems have tackled this specialty.
Ep. 005 – Dave Chase Podcast Transcript
Pharma Marketing Network
JUNE 8, 2020
Don (PMN): The specialty pharmacy. Dave (HR): Oh, no, I think the Specialty Pharmacy. Really, everybody likes getting rid of distant, unconnected, insurance bureaucracies and getting rid of waste and abuse and fraud. Don (PMN): Is that because it’s mostly online, or primarily online? Dave (HR): Which part?
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