Article
18 August 2025 - by Melody Craff, Kim Ren, Davin Hemmila, Ivanna Ulin, AJ Ally
Increased GLP-1 adherence may reduce medical costs for a growing number of chronic conditions, but savings don’t offset the high price of the medications.
Article
08 May 2025 - by Briana Botros, Julia Shelton, Kim Ren, AJ Ally
In a pilot of obesity care, Connecticut saved as much as 3% on medication spending, based on rejecting claims and switching members to lower net cost therapies.
Article
24 March 2025 - by Alan Van Amber, Michael T. Hunter, Jay Blomquist, AJ Ally, Ryan Cloninger, Stephen Wolff
The emergence of cost-plus reimbursement models in the pharmacy channel presents a promising alternative to better align reimbursement with acquisition costs.
Article
10 June 2024 - by Jake K. Klaisner, AJ Ally, Briana Botros, Kristin Niakan, Ryan LeRoy
We examine the impact of anti-obesity medication coverage in the Medicaid and commercial markets, as drugs such as Wegovy and Zepbound take off.
Article
25 August 2023 - by AJ Ally, Deana Bell, Melody Craff, Jeff Garbe, Mark F. Gruenhaupt, RPh, Peter Heinen, Ellyn Russo
We examine various strategies related to GLP-1 medications such as Wegovy when used for weight loss to help payers understand the landscape, develop a coverage strategy, and minimize waste.
Article
30 September 2022 - by AJ Ally, Matt Berman, Michelle (Klein) Robb, Kevin Pierce
Drug manufacturers should take the time now to understand how the Inflation Reduction Act will affect Medicare and carefully plan.
Article
16 April 2022 - by AJ Ally, Matt Berman
We discuss three primary targets to reduce prescription drug costs in the U.S., with potentially substantial changes in pricing for Medicare Parts B and D.
Article
04 February 2022 - by Jake K. Klaisner, Kali Schweitzer, AJ Ally
This report estimates the distribution of Myasthenia Gravis patients among Medicare Fee for Service, Medicare Advantage, Commercial, and Medicaid payer channels.
