Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. We talk with with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. When implemented, health plans or employers compare the costs of all brand-name and generic drig options within a certain therapeutic category and identify the lowest cost options. From there, copays are adjusted to encourage the use of the lowest cost alternatives, with plans covering the cost of a drug or service up until the reference point.
With research showing that these programs can reduce costs by an average 20% each year, we sat down with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
Listen above or through one of these podcast services:
Industry Experts Tackle Specialty Drug Access Challenges for Employer Benefit Plans
May 2nd 2024Representatives from ICON plc and Symphony Health joined forces at AXS24 to discuss the challenges of managing high-cost specialty drugs and how they influence self-funded employer benefit plan design and employee access to specialty medications.
Read More
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
Reducing Low-Value Care Is Hard, but What About Just Not Paying for It?
March 14th 2024After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.
Read More
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Lowering Cardiometabolic Drug Costs May Improve Diabetes Health Outcomes
February 9th 2024Patients enrolled in a preventive drug list (PDL) benefit saw an 8.4% reduction in acute, preventable diabetes complication days, and PDL members residing in lower-income areas saw a 10.2% decrease compared with control members.
Read More
Drug Prices and OOP Costs Increased Beyond Inflation Rates 2009-2018, But Were Not Related
January 31st 2024Drug prices in the US increased 4.4% annually and median out-of-pocket (OOP) costs increased 9.6% annually from 2009 to 2018, but there was no direct link between these amounts for individual drugs.
Read More