Oncology: Finding the Right Care Team

Situation The journey to treat cancer is arduous, complicated and expensive. Cancer care is the highest spend category for high-cost claimants in many employers’ health plans. Effective cancer care is a function of three key variables:   Timely discovery – early stage...

Managing the Spend Gain of OZEMPIC®

By Jake Steepleton, Rx Product Specialist Situation Spending on GLP-1 drugs which treat Type 2 diabetes and obesity has surged. Weekly prescriptions for OZEMPIC® soared 111% between Feb 2022 to Feb 2023, making it the costliest drug for many employers, surpassing...

Oncology Series – Enabling Timely Discovery

By Bill Frack, Chief Product Officer and Mike Maley, Head of Product Situation The journey to treat cancer is arduous, complicated and expensive. Cancer care is the leading category of cost for high-cost claimants in many employers’ health plans. Effective cancer care...

Rx Rebate Misrepresentation

Situation Who doesn’t love a good discount? There’s a reason why rebates have been around for over a century! Just as with common consumer goods, the pharmacy benefit manager model with up to 30% rebates appeals to our sense of shopping savvy. Through RFP processes,...

3 Reasons Your Stoploss Is Broken (And How to Fix It)

By Austin Johnson, Customer Success Team Lead Situation Stoploss reimbursements are critical to self-insured employers to mitigate the cost of catastrophic claims and to smooth out related financial shocks. Since 2012, the incidence of claims exceeding $1MM more than...