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The Pharmacist Write Resources Hub

I Built a Crawler for BCBS Illinois Drug PA Policies. Here’s What I Found—and Why It Extends Beyond Illinois

Managed Care Pharmacy

I Built a Crawler for Cigna’s Drug PA Policies. Here’s What I Found

Managed Care Pharmacy

I Built a Crawler for Medica’s Drug PA Policies. Here’s What I Found—and Why It’s Bigger Than Medica

Managed Care Pharmacy

I Built a Crawler for UnitedHealthcare’s Drug PA Policies. Here’s What I Found

Managed Care Pharmacy

I Built a Crawler for Highmark’s Drug PA Policies. Here’s What I Found

Managed Care Pharmacy

Humira’s Denouement: The Biosimilar “Cliff” That Became a Slope

Managed Care Pharmacy

You Can Appeal Your Denial. You Can’t Appeal the Policy.

Managed Care Pharmacy

The Risk Your Health Plan Can’t See: How Discount Drug Cards Hide True Costs

Managed Care Pharmacy

Class Policy vs. Individual Drug Policy: Cystic Fibrosis Medications as a Case Example

Managed Care Pharmacy

When the Claim Clears, but Access Doesn’t

Managed Care Pharmacy

A Small Ambiguity in Drug Coverage Criteria

Managed Care Pharmacy

The Employer’s Guide to PBMs & Drug Coverage

Managed Care Pharmacy

Beyond the PDF: Why We Need a “Compositional Grammar” for Coverage Rules

Managed Care Pharmacy

The 90% Problem: Why GenAI Alone Can’t Solve Prior Authorization

Managed Care Pharmacy

Policy Vault: from PDFs and Portals to FHIR‑Ready Coverage Rules

Managed Care Pharmacy

Part 9: Bonus — Underwriting Transparent Drug Coverage

Managed Care Pharmacy

Part 8: The Fall of Rebates and the Rise of NodeID — Toward Transparent, Fixed-Gain Drug Access

Managed Care Pharmacy

Sunset Strategy: How Amgen’s Repatha Shows the Future of Late-Stage Asset Pharma Pricing

Managed Care Pharmacy

How Pharmacy Payers Change Policy: A Process Overview

Managed Care Pharmacy

What a Simple Drug Prior Authorization Policy Looks Like

Managed Care Pharmacy

Designing a Value-Based Formulary in 10 Steps

Managed Care Pharmacy

Pharmacy Benefit Management Consulting: What You Need to Know

Managed Care Pharmacy

Knockout Gene-Inspired Prior Authorization Logic

Managed Care Pharmacy

How Pharmacy Benefit Analytics Improves Plan Efficiency & Cost Management

Managed Care Pharmacy

Drug Utilization Management 101: Rules, Tools & Best Practices

Managed Care Pharmacy

Part 7: Gradual Governance Transfer – Shifting from Centralized PBMs to a Distributed, Multi-Stakeholder Model

Managed Care Pharmacy

Part 6: Applying Elinor Ostrom’s Framework – How Institutional Diversity Shapes Drug Coverage Node Enumeration

Managed Care Pharmacy

Part 5: Drug-Coverage Node Enumeration: Real-World Applications, Pilot Opportunities, and Future Outlook

Managed Care Pharmacy

Part 4: Building an Open Infrastructure for Node-Based Drug Coverage

Managed Care Pharmacy

Part 3: Building the Exhaustive Parameter Library: Enumerating All Coverage Options

Managed Care Pharmacy

Part 2: Introducing Enumerated Node-Based Drug Coverage: Redefining the Manufacturer–Payer Interface in Pharmacy Benefits

Managed Care Pharmacy

Part 1: The Origins of Drug Coverage Centralization – Why a New Model Is Needed

Managed Care Pharmacy

An Insurer-Less Pharmacy Ecosystem?

Managed Care Pharmacy

From P&T Committee to Exchange Forum: The Evolution of Drug Coverage Decision-Making

Managed Care Pharmacy

Reimagining The Claims Processing Partnership Structure: How Outsourcing Powers a Next-Gen PBM Alternative

Managed Care Pharmacy

Transparent Admin Fee vs. Spread Pricing: A Better Revenue Model for Pharmacy Services

Managed Care Pharmacy

Facing Manufacturer ‘Retribution’ Fears: How to Create a Safe Harbor for Direct Payer Deals

Managed Care Pharmacy

Decoupling Risk-Bearing from Pharmacy Benefits Managers: A Brief Overview for Self-Funded Employers

Managed Care Pharmacy

Formulary Contracting Exchanges: Bridging Manufacturers, Employers, and Insurers

Managed Care Pharmacy

P&T as a Service (P&TaaS): Bringing Clinical and Financial Clarity to Employers

Managed Care Pharmacy

Pharmacy Residencies: Advancing Your Career Path

Managed Care Pharmacy

Pharmacists’ Role in Managing Drug Shortages

Managed Care Pharmacy

Pharmacy Technician Certification: Steps to Success

Managed Care Pharmacy

Ambulatory Care Pharmacy: Expanding the Pharmacist’s Role

Managed Care Pharmacy

Medication Therapy Management (MTM): Beyond Traditional Pharmacy Practice

Managed Care Pharmacy

Building a Successful Managed Care Pharmacy Practice: Key Principles and Strategies

Managed Care Pharmacy

Specialty Pharmacy Services: Managing High-Cost Medications Effectively

Managed Care Pharmacy

Collaborating with Adjacent Stakeholders: Expanding the Pharmacist’s Impact

Managed Care Pharmacy

Telepharmacy and Beyond: The Digital Transformation of Medication Counseling

Managed Care Pharmacy

Understanding Pharmacy Benefit Managers: What Every Pharmacist Should Know

Managed Care Pharmacy