Prescription drugs
We help navigate pharmacy benefit challenges
Milliman prescription drugs solutions
PBM contracting and management
Pharmacy plan design
Medicare Part D
Milliman prescription drugs insight
A payer’s guide to weight-loss medications
The glucagon-like peptide-1 (GLP-1) receptor agonist drug class—which includes diabetes drugs Wegovy and Ozempic—is proving effective at managing obesity, leading to surging demand.
Medicare Prescription Payment Plan: What do plan sponsors need to know?
Health plan sponsors need to understand the mechanics of the Medicare Prescription Payment Plan and prepare for the program’s operational complexity.
PBM Best Practices Series: Pharmacy benefit claims auditing
When seeking ways to keep expenses under control, plan sponsors may overlook the value of claims auditing.....
Payer strategies for GLP-1 medications for weight loss
Maximizing opportunities to efficiently manage pharmacy costs in Medicaid
As drug costs continue to rise, states need to engage in strategies that include policy and nonpolicy options to manage prescription spending in Medicaid.
PBM Best Practices Series: Clinical programs and value-based decision-making
A review of best practices for plan sponsors in evaluating clinical programs offered by pharmacy benefit managers.
PBM Best Practices Series: Effective contracting
One of the most important ways plan sponsors can lower healthcare costs without significantly changing their benefits is to look for opportunities to improve their pharmacy benefit manager (PBM) contract.
PBM Best Practices series: Rebate audit services
Auditing the administration of the pharmaceutical manufacturer rebate program, including dollars paid, is a proven strategy for improving plan sponsor profitability, prescription drug affordability, and the management of pharmacy benefit manager contracts.
PBM Best Practices Series: Carve-in vs carve-out programs
Employers and other plan sponsors have the option of carving in or carving out their pharmacy benefit program from medical benefits. Which strategy is right for you?