Articles tagged with “specialty-drugs”

QALYs & Quality of Life: Justifying Specialty Drug Costs

Learn how patient quality of life (QoL) data is quantified into Quality-Adjusted Life Years (QALYs) to perform cost-effectiveness analysis for specialty drugs.

35 min read

1/7/2026

qaly quality of life patient-reported outcomes cost-effectiveness analysis specialty drugs drug pricing health economics hta value-based pricing

US Specialty Pharmacies: A Guide to Mail-Order Providers

Updated 2026 guide to US mail-order specialty pharmacies. Covers $751B market, top players (CVS, Optum, Express Scripts), FTC PBM reform, Walgreens-Sycamore split, GLP-1 growth, and specialty drug distribution trends.

50 min read

11/12/2025

mail-order pharmacy specialty pharmacy specialty drugs pharmacy benefit manager healthcare distribution cvs specialty optum specialty pharmacy express scripts accredo vertical integration

Pharmacy vs. Medical Benefit Explained: GLP-1 Coverage

Learn the key differences between pharmacy vs. medical benefit and how this structure impacts insurance coverage for GLP-1 drugs for diabetes and obesity, including the 2025–2026 Medicare BALANCE Model, manufacturer price cuts, and employer coverage trends.

50 min read

11/7/2025

pharmacy benefit medical benefit glp-1 coverage semaglutide insurance benefits drug formulary pbm healthcare policy specialty drugs

Specialty Pharmacy: An Analysis of Key Players & Trends

An in-depth analysis of the specialty pharmacy industry covering key players (PBMs, distributors), market trends, biosimilar competition, PBM reform, and the economics of high-cost specialty drugs. Updated March 2026.

45 min read

11/3/2025

specialty pharmacy specialty drugs pharmacy benefit manager drug spending pbms gene therapy biosimilars