ICER Value Framework

WHAT IS ICER? An organization most patients never heard of is now hard at work determining whether recently approved drugs for serious and often life-threatening diseases should be covered by private health plans and made available to patients. Called the Institute...

Taking a Stand: Safety Concerns with Drug Importation

The Issue To reduce patients’ spending on prescription drugs, both Congress and a number of states are considering legislation that would allow Americans to purchase supposedly much cheaper medicines from Canada and elsewhere, which could put Americans’ health and...

Telling the Truth About Copay Accumulators

In 2018, many insurers and pharmacy benefit managers (PBMs) introduced copay accumulator programs to the American public, using such pleasant sounding names as “Out of Pocket Protection” and “Coupon Adjustment: Benefit Plan Protection” to lull consumers into believing...

Fighting Nonmedical Switching

Under a practice known as nonmedical switching, pharmacy benefit managers (PBMs) can force patients to change from a medication they rely on to a less costly and possibly less effective drug for financial reasons, not medical ones. PBMs accomplish this by dropping the...