Most plans have a precertification process in place for high-dollar drugs that addresses the appropriateness for diagnosis as well as provider network status; however, this is where it stops.
Read moreUpdate: Expanded Criteria Organ Transplants
For people awaiting a transplant, expanded criteria donor (ECD) organs may bridge the gap between life and death. ECD availability can separate those on the waiting list from those who will die before receiving their needed organ.
Read moreKidney Disease Management Collaboration with Renalogic
Summit Reinsurance Services, Inc. announced a strategic collaboration with Renalogic, a solution provider offering risk management services for kidney disease. Renalogic uses a data-driven approach focused on predicting and preventing chronic conditions that lead to dialysis.
Read moreSpecialty Pharmacy Services Collaboration with AscellaHealth
Summit Reinsurance Services, Inc. announced a strategic collaboration with AscellaHealth, a pharmacy benefit manager offering innovative specialty drug programs developed as specialized solutions to the biggest drivers of pharmacy claims.
Read moreAre You Ready? Preparing for Gene and Cell Therapies Coming Down the Pipeline
Gene and cell therapies can be life changing but come with expensive price tags. As more therapies are FDA approved, payers are looking for options to control the spiraling cost of specialty pharmacy and to project future financial risk related to new therapies coming to market.
Read moreGene Therapy for Hemophilia A: Valrox may be the world’s most expensive one-time treatment
Should it be approved, BioMarin is considering pricing Valrox, a gene therapy drug aimed at hemophilia A, at $2 million to $3 million for the single treatment.
Read moreZolgensma and Gene Therapy: What is the Cost?
Gene therapy in healthcare has become a reality, and it is set to move from a trickle to a stream in the next few years. This article discusses Zolgensma and other emerging gene therapies in the context of how they may affect a health plan’s costs.
Read moreNew Specialty Pharmacy Program for Summit Re Clients
Summit Reinsurance Services, Inc. today announced a strategic collaboration with RxResults, a pharmacy risk manager. Through this collaboration, Summit Re clients will have access to proprietary informatics, clinical expertise, and business processes to help formulate actionable insights and implement evidence-based strategic initiatives in order to manage pharmacy and specialty pharmacy spend.
Read moreSummit Re Announces Collaboration with Deerwalk, Inc.
Summit Reinsurance Services, Inc. today announced a strategic collaboration with Deerwalk, Inc., an innovative population health management, data management, and healthcare analytics software company. Through this collaboration, Summit Re clients will have access to the most complete population health management suite in the industry. Efficient and accurate data collection, intake, enrichment, and reporting, will allow participating clients to obtain a full picture of their risk portfolio in order to make more effective management decisions.
Read moreTransplantation and Expanded Criteria Donors: Hepatitis C
This shortage of available organs has led to the increased use of Expanded Criteria Donors in transplant centers for many different organs. This article discusses liver transplant recipients who are hepatitis C negative and receive a liver from an expanded criteria liver donor who is Hepatitis C positive.
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