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Evolution of the use of restrictions in commercial formularies03 November 2016 - By Gabriela Dieguez and Harsha Mirchandani and Tia Goss Sawhney - Article

This report uses drug formulary data covering over 150 million lives in the U.S. to examine trends in the use of prior authorization, step therapy, and formulary exclusion in commercial formularies for the years 2011 to 2016.

Regulatory oversight in Medicare Advantage24 June 2016 - By Catherine M. Murphy-Barron and Gabriela Dieguez - Article

This report explores the body of rules and regulations that affect Medicare Advantage bids, revenue, and benefit design.

2016 reflections on the favorable cost-benefit of lung cancer screening23 May 2016 - By Bruce S. Pyenson and Gabriela Dieguez - Article

This article gives a basic background on cost-benefit analyses in healthcare, using lung cancer screening as a case study.

The impact of pre-deductible features in select marketplaces06 May 2016 - By Bruce S. Pyenson and Gabriela Dieguez and Katherine Simon - Article

This report illustrates the potential impact on premiums and out of pocket costs if some of the existing popular plans in the individual federally funded marketplace shifted to standardized benefits.

Impact of increasing the Medicare Part D specialty threshold16 October 2015 - By Bruce S. Pyenson and Gabriela Dieguez and Jennifer Carioto - Article

This report examines the changes to member cost sharing for users of specialty drugs that would no longer exceed the Medicare Part D threshold.

Understanding the Part D spending dynamics of heart failure patients18 August 2015 - By Bruce S. Pyenson and Gabriela Dieguez and Michael Bellanich - Article

Understanding the drug spending by heart failure patients requires an evaluation of the complex interactions between members, payers, and manufacturers in Part D.

Aging will affect Medicare’s Hepatitis C mortality and cost16 July 2015 - By Bruce S. Pyenson and Gabriela Dieguez and Ryan Cannon - Article

This paper examines the mortality and cost dynamics affecting Medicare as the majority of Hepatitis C Virus (HCV)-infected people age into Medicare.

Peru preparing to take its healthcare the next step forward19 January 2015 - By Gabriela Dieguez - Article

Since the beginning of 2014, Peru has been developing a broader healthcare system to give care to those most in need.

Specialty tiers: Benefit design considerations for Medicare Part D26 June 2013 - By Bruce S. Pyenson and Gabriela Dieguez and Rebecca L. Johnson - Article

An examination of benefit design and costs for specialty-tier prescription drugs.

Specialty tiers: Benefit design considerations for commercial payors16 October 2012 - By Bruce S. Pyenson and Gabriela Dieguez and Rebecca L. Johnson - Article

Plan redesigns can help reduce the cost impact of specialty drugs without burdening patients or payors.


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