Webinar Series: Managing the Pharmacy Benefit Manager

Be sure to join us  on May 11th for our upcoming webinar outlining strategies to help better manage your PBM. With costs in the Rx space skyrocketing, many plan sponsors are looking at changes to plan design, drug tiers, and delivery channels to increases. There are ways to ensure your plan is running as efficiently as possible without disruptions to your members. Allow us to share some data-driven strategies to contain Rx costs by managing your PBM.

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No Ready-Made Rx for Rising Drug Costs

When Turing Pharmaceuticals raised the price of an older generic drug by more than 5,000 percent last month, the move sparked a public outcry. apothecary-437743_640How, critics wondered, could a firm charge $13.50 a pill for a treatment for a parasitic infection one day and $750 the next?

The criticism led Turing’s unapologetic CEO to say he’d pare back the increase – although no new price has yet been named – and the New York attorney general has launched an antitrust investigation. The outcry has again focused attention on how drug prices are set in the United States. Aside from some limited government control in the veterans health care system and Medicaid, prices are generally shaped by what the market will bear. more

For A Long And Healthy Life, It Matters Where You Live

It’s not just how long you live that matters. It’s healthy life expectancy – the additional years of good health you can expect once you hit 65.

And by that measure, a new analysis shows it makes a lot of difference where Americans live.

Hawaiians are lucky in more than their idyllic weather and gorgeous scenery. Seniors there can expect a little more than 16 years of healthy life after 65. Women in Hawaii can expect more than 17 years.

At the other extreme, Mississippi’s seniors have less than 11 years of healthy life. Older black Mississippians have only eight years, lower than anywhere except, oddly, African-Americans in Iowa, with seven years.

Read More NPR Shots Health News

The Wall Street Journal — Insiders Guide to Pittsburgh, Pa. – WSJ.com

Pittsburgh is the home to a booming downtown culture that is continuing to undergo a transformation from its days as the worlds steel super-producer. TFG Partners is proud to be located int the heart of the “Golden Triangle” and be part of this renaissance. To show our ” Burg Pride” we extend to you this great article and guide from the Wall Street Journal:

Via The Wall Street Journal:

THIS IS ONE RUST BELT town that’s gotten a polish. After decades of losing jobs and residents, Pittsburgh has become a standard-bearer for urban revitalization.

Joining its distinctive, bridge-studded skyline are ambitious buildings like the modernist Tower at PNC Plaza, expected to open in 2015 as the world’s greenest skyscraper, and the Gardens at Market Square, a $90 million high-rise. Downtown is undergoing a gold rush, with old factories and closed department stores being converted rapid-fire into apartments and spaces for new businesses.

Read more on the WSJ — Journal Concierge: Insiders Guide to Pittsburgh, Pa. – WSJ.com.

More Data Showing Wide Variations in Hospital Pricing

Early this morning, HHS released a data set encompassing the billing prices for popular procedures at over 3,000 of the nation’s hospitals. The data shows how different procedure costs can be from hospital to hospital. There are many news outlets running this, we have added a sampling below. We hope this furthers the discussion and enables the industry to have a greater dialogue about transparency in healthcare.

World Health Organization works to end Polio

A vaccine for Polio has been available since Dr. Jonas Salk and his team here at the University of Pittsburgh developed and tested it in 1955. In the ensuing 58 years, we have yet to destroy this debilitating disease globally. This past week, the World Health Organization announced a $5.5 Billion dollar plan to eradicate Polio forever. From where we sit in Pittsburgh where this battle started, we hope that this plan is a huge success.

The NPR – “Shots” Healthcare Blog has written a nice article on the topic:
A $5.5 Billion Road Map To Banish Polio Forever : Shots – Health News : NPR.

Forbes: To Bring Healthcare Prices Down, Consumers Must Demand Price Transparency

Healthcare price transparency is on the leading edge to finding the solution. This article by Giovanni Colella ties back in with last month’s Time Magazine article and continues to highlight

Credit: PinkBlue / FreeDigitalPhotos.net

Credit: PinkBlue / FreeDigitalPhotos.net

the nessesity of making pricing of procedures public and transparent.  At TFG Partners, we receive pushback on requests from administrators for necessary pricing information. Along with other industry leaders, TFG Partners will continue to work on the forefront to gain the upper hand for our clients.

To Bring Healthcare Prices Down, Consumers Must Demand Price Transparency




Time Magazine Article: Bitter Pill, Why Medical Bills Are Killing Us

Credit: Time Magazine

Cover of March 4, 2013 Time Magazine

Much has been said since the March 4, 2013 issue of Time Magazine hit news stands this week. Steve Brill’s cover story ‘Bitter Pill’ looks at the healthcare debate by trying to answer one question:  Why does healthcare cost so much? The media has grabbed the story and been outraged at the cost of care, the skyrocketing bills, and the way we as a nation have allowed the system to take over our economy.

Truth is,  we at TFG Partners think this is a fantastic article to start the discussion. We have been working to curb health plan spending for our clients for over 20 years. While this story is written with the prospective of a single patient experience, imagine how our healthcare system exasperates the problems when looking at a full self-funded health plan. On behalf of our clients we have been identified overpayments, plan benefit discrepancies, and process improvements for their plans for over 20 years.

We recommend you read the article (subscription required) and take a look at the coverage below.

Why Medical Bills Are Killing Us | TIME.com.

Inside ‘Bitter Pill’: Steven Brill Discusses His TIME Cover Story.

Who profits off your hospital bills? – Anderson Cooper 360 – CNN.com Blogs.