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Pharmacy Plan Design



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The Evolving Pharmacy Landscape
A Business Group/BCBSA collaboration focused on consumers' perspectives on pharmacy issues, such as coupons and medication costs; paired with employers' perspectives.
Oct 18, 2019
The Evolving Pharmacy Landscape Infographic
An infographic highlighting consumers' and large employers' perspectives on pharmacy issues, such as coupons, medication costs and government intervention.
Oct 18, 2019
Today's Evolving Pharmacy Landscape: The Consumer Perspective
This webinar highlights the results of a recent Business Group/BCBSA collaboration focused on consumers' and large employers' perspectives on pharmacy issues.
Oct 18, 2019
Fall 2019 Outlook in Congress for Health Care Legislation
Hear an overview of key health care issues facing congress, including: repeal of the excise tax on employer plans, surprise billing, and prescription drug pricing and competition.
Sep 27, 2019
House Speaker Releases Drug Pricing Proposal
Last week, Speaker Pelosi released a proposal similar to the Trump Administration's plan to deal with rising prescription drug prices. The House began hearings but the future is uncertain amidst competing proposals and disagreements within parties about the path forward .
Sep 25, 2019
HIV/AIDS: Despite Progress, Much Work Remains
This Issue Brief details the transformation of the HIV/AIDS treatment landscape and offers suggestions for what employers can do to help eradicate the disease once and for all.
Sep 19, 2019
Key Insights from Business Health Agenda 2019
From April 10 to April 12, over 500 participants explored whether the U.S. health care industry was at a tipping point. Attendees brainstormed about ways to influence change that ensures that this transformational period results in a system that is not only sustainable from a cost perspective, but also meets the needs of the employees and consumers.
Sep 10, 2019
Large Employers' Health Care Strategy in 2020 (Part II)
Slides from the September 5 webinar that shared key results from the Business Group's annual Large Employers' Health Care Strategy and Plan Design Survey along with forward-thinking employers who will provide real-world application of the findings to their own strategy.
Sep 5, 2019
Large Employers' Health Care Strategy in 2020
along with forward-thinking employers who will provide real-world application of the findings to their own strategy.
Sep 4, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Full Report
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions to provide insight into large employers' views on the rapidly changing health care landscape. Large employers were asked about their evolving role in bringing about change in health care, their thoughts about proposed policy changes and the position of virtual solutions in their offerings.
Aug 13, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Pharmacy Costs and Strategies
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions focused on solutions to high-cost therapies and other specialty medications. In addition, employers were asked about copay assistance programs and point-of-sale rebate programs.
Aug 13, 2019
Results from the 2020 Large Employers' Health Care Strategy and Plan Design Survey: Press Briefing
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions to provide insight into large employers' views on the rapidly changing health care landscape. The press briefing covered 10 key insights into how large employers are approaching the delivery system, policy, pharmacy, health care cost management and more.
Aug 13, 2019
Key Insights from the 2019 Employers' Summit on Health Care Cost and Solutions
The Employers' Summit on Health Care Costs and Solutions is an annual, employer-only meeting hosted in the Business Group's offices in Washington, DC. The event focused on key trends in health care, policy and actionable steps human resources professionals can take to improve health outcomes and reduce health care costs. The following is a brief look at some of the most compelling insights from the 110 employer-strong summit.
Jun 6, 2019
Employer Perspectives on Pharmacy Priority Topics, Maternity/New Parents and High-Cost Conditions - February 2019
Key insights from the February 2019 Industry Benchmarking Call Series, covering the following topics: pharmacy priorities, maternity/new parents and high-cost conditions
Feb 28, 2019
Let's Get a Grip on Arthritis
This installment in the Specialty Pharmacy Management Series highlights challenges surrounding access to arthritis treatment and offers various employer plan design considerations that are centered on affordability, care management (continuity of care) and access to insurance coverage and providers.
Feb 13, 2019
Rx Alert: 510(k) Products – Drugs Masquerading as Medical Devices on Your Pharmacy Benefit Plan
Drug-like products, largely in the dermatologic space, are gaining coverage on your benefit plans through the 510(k) medical device approval pathway. The following Alert highlights this challenge from a cost and plan design perspective and raises patient safety concerns. Learn how to get out ahead of the issue!
Jan 30, 2019
Employer Perspectives and Health Care Trends Across 10 Industries - October 2018
Key insights from the October 2018 Industry Benchmarking Call Series, covering the following topics: the employer role in health care, provider consolidation, virtual care and artificial intelligence, pharmacy supply chain and health care cost trend.
Jan 29, 2019
Drug Manufacturer Patient Assistance Programs
This Numbers You Need Slide looks at employers' perspectives and programs around patient assistance programs.
Nov 2, 2018
Manufacturer Rebates
This Numbers You Need Slide looks at employers' perspectives around the rebate model and alternatives to that model.
Nov 2, 2018
Rebate Models and Alternatives
This Numbers You Need Slide looks at employers' perspectives around the rebate model and alternatives to that model.
Nov 2, 2018
Top Cost Drivers of Health Care Costs
This Numbers You Need Slide looks at the top cost drivers that are effecting rising health care costs
Nov 2, 2018
Key Insights from Business Health Agenda 2018
Business Health Agenda (BHA) is an annual conference hosted by the National Business Group on Health®, highlighting the latest trends, best practices and innovative tactics for employer-sponsored health benefits and health care initiatives. Read more about the main takeaways from the three day event.
Oct 11, 2018
What is ICER and Why Should Employers Care?
NBGH September 18, 2018 Webinar Slides from Dr. Steve Pearson (ICER) and Dr. Surya Singh (CVS Health)
Sep 18, 2018
Coming Down the Pipeline: What's on the Horizon and How to Mitigate Your Plan's Exposure to Risk
This webinar takes a look at the historical impact of big-ticket specialty medications that are driving trend and learn what to look out for in the near future in terms of critical and/or costly new drugs entering the market.
Sep 13, 2018
What Your CEO Is Reading - Challenging Pharmaceutical Rebates
Media attention has continued focus on the dysfunction in the pharmaceutical supply chain model and its contribution to high and rising drug prices.
Aug 2, 2018
Rx Alert: CDC Guidelines on Opioid Prescribing
Learn how to work with your pharmacy vendor(s) to reduce risk of opioid addiction.
May 4, 2018
Opioids on the Job: A Multi-part Series on Addressing a Crisis in the American Workforce, Session II Presentation
Round two in the opioid series focused on "conservative care" approaches to pain management, with a goal of avoiding opioid exposure.
Apr 26, 2018
Pharmacy Benefits Among Large Employers: A National Business Group on Health Infographic
The information provided in this infographic has been taken from a collection of Quick Surveys performed by the Business Group.
Apr 4, 2018
The Employer Response to Opioids: A National Business Group on Health Infographic
The information provided in this infographic has been taken from a collection of Quick Surveys performed by the Business Group.
Apr 3, 2018
Key Insights from the 2018 Employers' Summit on Health Care Cost and Solutions
The Employers' Summit on Health Care Costs and Solutions is an annual, employer-only meeting hosted by the National Business Group on Health focused on key trends in health care, policy and leadership in human resources. This resource summarizes the key insights and lessons from the meeting on health care costs, employee engagement, delivery system strategies, specialty pharmaceuticals, mental health and more.
Mar 13, 2018
What Your CEO is Reading: Cigna to Acquire Express Scripts
Cigna is nearing a deal to buy Express Scripts in a transaction that is believed to be worth more than $50 billion.
Mar 8, 2018
What Your CEO Is Reading: Point of Sale Rebates
UnitedHealth Group to pass pharmaceutical manufacturer rebates to consumers at the point of sale (POS)
Mar 7, 2018
Opioids on the Job: A Multi-part Series on Addressing a Crisis in the American Workforce
Session I of the Opioid Summit focused on understanding claims data, treatment and coverage issues, and tackling stigma.
Feb 9, 2018
Specialty Pharmaceuticals: High Prices Getting Higher and What Employers Can Do
Expenditures for specialty drugs continue to grow faster than any other component of health care spend, despite being used by only 2% of the population. Open to learn more about what your peers are doing and how you can leverage shifting industry dynamics to lower your pharmaceutical spend and enhance the value of care your employees receive.
Jan 11, 2018
Supporting Employees with Multiple Sclerosis: High Cost Claimants Webinar Series Part VIII
This webinar slide presentation features information from the National Multiple Sclerosis Society about the scope and impact of multiple sclerosis (MS), as well as how employers can support employees and their children living with MS.
Jan 10, 2018
Industry Insights from the Large Employers' 2018 Health Care Strategy and Plan Design Survey
This special report looks at industry insights from the National Business Group on Health's Large Employers' 2018 Health Care Strategy and Plan Design Survey.
Jan 5, 2018
An Employer's First Steps Toward "Paying for Value": Amgen Tackles Value-Based Insurance Design
In this webinar, Amgen Inc. discusses the first steps they have taken, in partnership with University of Michigan, to implement a value-based insurance design approach.
Dec 13, 2017
Value-Based Drug Purchasing
Health plans, PBMs, pharmaceutical manufacturers and employers are beginning to implement value-based drug purchasing (VBP) arrangements, with the hope of changing the fee-for-service reimbursement paradigm for drugs. This fact sheet lays out several drug VBP strategies and details early results from pilot programs.
Dec 11, 2017
What Your CEO is Reading - CVS Health to Acquire Aetna
Open to learn more about the proposed merger and whether and how it may affect your company's health benefits and future health strategy.
Dec 6, 2017
High-Cost Claimants Webinar Series - Hemophilia
In this webinar, an expert from the National Hemophilia Foundation discusses the rare disorder of Hemophilia and ways to significantly drive down costs and improve outcomes for patients afflicted by this disease.
Nov 30, 2017
Biosimilars: Part II
Is your organization prepared to achieve savings through biosimilar utilization? In this webinar, Wal-Mart Stores, Inc. leads biosimilar manufacturers Pfizer and Sandoz in a round-two discussion centered on how employers can best incorporate biosimilars into plan design.
Nov 28, 2017
High-Cost Claimants Webinar Series - Unintentional Injuries
In this webinar, the Centers for Disease Control and Prevention (CDC) discusses the trends of the opioid overdose epidemic and the National Safety Council discusses results from their national survey of employers, tools available to employers facing this epidemic, and employer-focused prevention and support strategies.
Nov 16, 2017
What Your CEO is Reading: Opioid Public Health Emergency
President Donald Trump declared the nation's opioid crisis a "public health emergency," underscoring employer concerns with this growing epidemic.
Oct 26, 2017
Preventive Health Through Genetics: The New Company Health Benefit
This webinar presentation details how genetics is changing the role of prevention in health care today and how leading companies, such as SAP, are turning to genetics as an integral pillar of their overall preventive health strategy.
Oct 4, 2017
Cancer Gene Therapy Approved – What does this mean for employers?
On August 30, 2017, the New York Times reported on a landmark decision made by the Food and Drug Administration (FDA) to approve the first-ever gene therapy to be available in the United States, bringing treatment options to a rare form of cancer for pediatric and young adult patients. Read more about what this means for employers and ways to address gene therapy through benefits and programs.
Aug 31, 2017
Supporting People with Rare Diseases: High Cost Claimants Webinar Series Part I
This webinar slide presentation features information from the National Organization For Rare Diseases about the scope and impact of rare diseases, as well as how employers can support employees and their dependents living with these impactful, high cost conditions.
Aug 15, 2017
Executive Summary: Large Employers' 2018 Health Care Strategy and Plan Design Survey
Highlights the key findings from the Large Employers' 2018 Health Care Strategy and Plan Design Survey
Aug 8, 2017
Large Employers' 2018 Health Care Strategy and Plan Design Survey
Results from this survey indicate that employers are looking to new methods of controlling health care costs, improving outcomes and increasing satisfaction for their employees, both through demand-side (e.g., implementing CDHPs, modifying plan design and cost-sharing strategies, adding price transparency tools) and supply-side initiatives (e.g., telehealth, on-site clinics, Centers of Excellence, Accountable Care Organizations, etc.).
Aug 7, 2017
Large Employers' 2018 Health Care Strategy and Plan Design Survey: Chart Pack
Results from this survey indicate that employers are looking to new methods of controlling health care costs, improving outcomes and increasing satisfaction for their employees, both through demand-side (e.g., implementing CDHPs, modifying plan design and cost-sharing strategies, adding price transparency tools) and supply-side initiatives (e.g., telehealth, on-site clinics, Centers of Excellence, Accountable Care Organizations, etc.).
Aug 7, 2017
Biosimilars: A Checklist
Is your organization prepared to achieve savings through biosimilar utilization? Learn how to manage these new drugs in plan design!
Jul 11, 2017
NBGH Comment Letter to the FDA regarding Interchangeability Guidance for Industry
NBGH comments to outline that our membership supports the robust uptake of biosimilars in the marketplace, while ensuring that patients have access to safe, high quality treatments and therapies.
May 17, 2017
Rx Coupons – Consumer saver or cost driver?
This Rx Alert shares real-time, actionable insights on how to address copay coupon management in plan design.
Mar 20, 2017
Biosimilars: A Checklist
Is Your Organization Prepared to Achieve Savings Through Biosimilar Utilization? The following checklist provides tips for getting you there.
Feb 3, 2017
Rx Alert: Online Pharmacies
This Rx Alert highlights the shocking prevalence of fraudulent online pharmacies that sell counterfeit and adulterated medicines and provides tips for ensuring that employees steer clear of these online traps.
Feb 1, 2017
A Closer Look at Rx Coupons and Patient Assistance Programs
This document offers employer considerations and management strategies relating to copay coupons and patient assistance programs.
Nov 14, 2016
Rx Alert: DAW Penalties May Artificially Inflate Discount Performance of Generic Drugs
This Rx Alert describes how DAW penalties may be used to artificially inflate discount performance of generic drugs and provides steps that employers can take to ensure that this does not happen.
Nov 14, 2016
Against the Grain: One Company's Innovative Approach to Pharmacy Benefit Management
Praxair, Inc., an American worldwide industrial gases company, and Integrity Pharmaceutical Advisors, LLC share Praxair’s innovative approach to pharmacy benefit management.
Nov 8, 2016
Specialty Pharmacy Costs, by Therapy Class
This Numbers You Need chart examines how pharmacy costs are projected to increase over the next three years for the most expensive specialty drug therapy classes.
Oct 11, 2016
Prescription Opioid Misuse and Abuse - 2016 Update
As the negative impact of prescription opioid misuse and heroin epidemic grows, private and public efforts to tackle the problem have accelerated in the past two years. This update reviews recent progress and outlines employer strategies to stem the problem while delivering assistance to employees and dependents in need.
Sep 22, 2016
What Your CEO is Reading - Anti-Inflammatory Specialty Drugs
This newsletter highlights a New York Times articles about a new effort to address high-priced anti-inflammatory specialty medications taken by millions of people for conditions such as rheumatoid arthritis, psoriasis and Crohn’s disease. The rising costs associated with these drugs are a result of the increase in the price of these medications and an increase in the number of patients using them.
Sep 12, 2016
National Business Group on Health’s Position Statement on Opioids
Policy makers should advance efforts to control prescription opioid abuse, which represent a substantial and growing economic and social burden.
Sep 7, 2016
Select Recent Examples of Publicly Disclosed U.S. Value-Based Pricing Arrangements
The chart contains recent examples of publicly disclosed value-based purchasing arrangements between pharmaceutical manufacturers and payers.
Sep 7, 2016
Prescription Drug Benefit Cost Trend
This Numbers You Need chart looks at how prescription drug cost trend over time.
Aug 19, 2016
Specialty Pharmacy Management: A Checklist
This checklist provides tips for staying ahead of the curve when it comes to managing specialty pharmacy in plan design.
Aug 2, 2016
Biologics Competition: An Update on the Market and Future Policy Actions
Understanding how public policy will impact employers ability to utilize biosimilar drugs in place of high price branded specialty/biologic drugs.
Jul 29, 2016
Rx Alert: Compounds - They're Back!
Rx Alert shares real-time, actionable insights based on information received through our National Committee on Pharmacy Benefits and Specialty Medicine as well as relationships with PBMs, consultants and employer members that can help you identify the next issue impacting the quality and cost of your pharmacy program.
Jul 20, 2016
NBGH Rx Alert: Lidocaine
Rx Alert shares real-time, actionable insights based on information received through our National Committee on Pharmacy Benefits and Specialty Medicine as well as relationships with PBMs, consultants and employer members that can help you identify the next issue impacting the quality and cost of your pharmacy program.
Jul 6, 2016
What Your CEO is Reading - Value-Based Contracts for Specialty Drugs
This newsletter highlights a recent news article on value-based pricing agreements, which is when manufacturers share in the financial risk if medications don't work as intended.
May 13, 2016
Opioid Misuse: What Employers Can Do
Prescription opioid and heroin use has become an epidemic in the U.S., with tens of thousands of American dying from overdose each year. New research reveals the extent to which this affects large employer plan members. This presentation reviews the evidence and provides recommendations for employers.
May 10, 2016
What Your CEO is Reading - Drug Pricing
This newsletter highlights recent articles that report on drug spending in 2015 based on data from the nation's two largest PBMs. Spending increased by approximately 5% in 2015. This increase, while twice the consumer price index (CPI), is significantly less than that of 2014, despite similar price inflation patterns - a sign that aggressive management of prescription drugs by the PBMs is working to help mitigate overall drug spend and to at least temper inflationary forces.
Mar 22, 2016
Spike in Lyme Disease Cases Calls for Employer Action
The number of counties in the Northeastern U.S. considered to have a high rate of Lyme disease grew by 320%, from 1993 to 2012, and the areas in which Lyme disease is found are growing. If left untreated, Lyme disease poses significant health threats. This Employer Alert provides recommendations for employers as they seek to help prevent and treat Lyme disease amongst their population.
Oct 22, 2015
Right Care, Right Place, Right Health Professional: Site of Care Benefit Manager Guide
This Benefit Manager Guide reviews the reasons employers are paying attention to where their employees seek care and provides best practice recommendations to encourage employees to obtain care from high-value settings.
Feb 27, 2015
2015 Pharmacy Trends and Hot Topics
The purpose of this webinar is to highlight pharmacy trends and hot topics facing employers in 2015 and to showcase how one employer has successfully managed pharmacy costs.
Feb 5, 2015
The Increasing Use of ADHD Medication Among Adults
This Employer Alert highlights the growing use of ADHD medications among adults and provides recommendations for the safe and appropriate use of these drugs.
Oct 28, 2014
The Evidence on Preventive Medications for Migraine Headaches: Advantages and Disadvantages
Provides a summary of the the effectiveness and safety of preventive pharmacologic treatments for adults with episodic or chronic migraine.
Oct 16, 2014
Employer Alert on Rising Costs of Vaccines and Generic Medicines
An overview of alarming trends in the cost of vaccines and generic medicines that have been on the market for many years and strategies employers can use to address the issue.
Oct 3, 2014
Compounded Medications
The purpose of this survey was to gauge employers’ perspectives on compounded medications, and if they planned on taking any steps to manage their use or cost. Forty-eight members of the Business Group responded to this survey.
Sep 30, 2014
Benefit Manager Guide: Integrating Precision Medicine into Benefits
Precision medicine has the potential to be cost-effective, and even cost-saving, by helping employees or dependents avoid ineffectual or harmful drug therapies. This guide provides employers with the business case for the value of precision medicine and offers recommendations on how to integrate precision medicine into benefits.
Apr 8, 2014
Treating disruptive behavior in people with dementia: Antipsychotic drugs are usually not the best choice
This resource is intended to engage consumers in important conversations with their physicians about when it's appropriate for people with dementia to take antipsychotic drugs. It was developed by Consumer Reports in cooperation with the American Geriatric Society for Choosing Wisely, a project of the ABIM Foundation.
Oct 23, 2013
Precision Medicine 101
Precision medicine has the potential to be cost-effective, and even cost-saving, by helping employees or dependents avoid ineffectual or harmful drug therapies. Describes eight actions employers can take to incorporate precision medicine into a benefit plan.
Oct 4, 2013
Prescription Drug Shortages
Explains the growing problem of prescription drug shortages: why it happens, which drugs are affected and what employers can do about it.
Sep 23, 2013
Employer Alert: New FDA-Approved Drugs to Treat Overweight and Obese Adults
In mid-2012, the U.S. Food and Drug Administration (FDA) approved the first new weight loss drugs in 13 years. The approval and availability of Belviq and Qsymia expands the range of medical options for treating overweight and obesity and requires plan sponsors to consider/reconsider if and how to cover weight loss drugs.
Aug 21, 2013
The Buzz on BRCA Gene Mutations: What Employers Need to Know
The resources and information are intended to assist employers and benefit managers in understanding and explaining the issues around the high-profile issue of the BRCA gene mutation and breast cancer.
May 23, 2013
Treating migraine headaches: Some drugs should rarely be used
This resource is intended to engage consumers in important conversations with their physicians about appropriate drugs to treat migraine headaches. It was developed by Consumer Reports in cooperation with the American Academy of Neurology for Choosing Wisely, a project of the ABIM Foundation.
Mar 27, 2013
Medication Non-adherence and Disability: New Cost Implications and Solutions
Non-adherence to medications is linked to greater incidence of short-term disability and greater costs per case. Employers can create significant cost savings by addressing recommendations to increase employee medication adherence.
Sep 1, 2012

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