Current issues and recommendations to manage prescription drug benefits for public health programs.

Higher scrutiny is befalling public payors regarding drug costs and patient access to medications. These issues exist in a complex contractual environment where minimal oversight of pharmacy claim adjudication and reimbursement practices can occur. The complexity of prescription benefits, and the lack of defined expectations or accountability in the system contribute to a sense of frustration by the public. Key areas of improvement for this sector of the health care industry include legislative and regulatory shifts requiring ongoing analyses, reporting, and accountability of pharmacy benefit managers (PBMs) in order to improve payment transparency. These improvements will enable plans to eliminate misaligned incentives in the industry and drive value. Changes in public sector programs should be comprehensive in their approach so that the policy will result in a reduction in costs, enhanced patient access, better patient safety, and improved health outcomes.

Understanding heterogeneity in adaptation to retirement: a growth mixture modeling approach.

Previous research has shown that as people transition to retirement they display heterogeneous growth in outcomes. Typically three subgroups are observed, in which people either increase, decrease, or maintain their scores over time. Extending this research, this study investigates whether subgroups exist independent of the retirement event and compares growth in two outcome measures--retirement adjustment and life satisfaction. Survey data were collected from 360 retirees across three time points. For life satisfaction, growth mixture modeling identified three distinctly growing subgroups. The majority maintained their scores over time, and two smaller groups showed increases and decreases in life satisfaction over time. No subgroups were identified for retirement adjustment. Implications of these results are discussed and suggestions are made for future research.