Blue Shield of California is cutting many of its ties with CVS Caremark (though not all) and adding four additional partners for its prescription drug benefits. These partners include Mark Cuban Cost Plus Drug Company and Amazon Pharmacy. The changes are needed to disrupt the current broken system, said Salina Wong, senior director of clinical pharmacy programs at Blue Shield of California.
CVS Caremark and GoodRx created a new program called Caremark Cost Saver, which will become available starting January 1, 2024. Through the program, eligible CVS Caremark commercially insured members will have access to GoodRx’s prescription pricing on generic medications.
James Comer (R-Ky), House Committee on Oversight and Accountability chairman, sent letters to the Office of Personnel Management, Centers for Medicare and Medicaid Services and the Defense Health Agency asking for documents that show how PBMs’ practices are affecting federal government healthcare programs. In addition, he sent letters to CVS Caremark, Express Scripts and OptumRx, asking them to provide information on their tactics.
The largest six pharmacy benefit managers are being scrutinized by the Federal Trade Commission, while Congress is debating the Pharmacy Benefit Transparency Act. Meanwhile, states have their own ideas for reining in what they see as excesses of the industry. With all this heat, what is the message from the head of the Pharmaceutical Care Management Association?
Here is a selection of recent executive hires, departures and layoffs occurring across the healthcare industry.
High prices have drawn other critics, as well, including President Joe Biden. He renewed his call for a broad price cap during his annual State of the Union address. Pharma companies insist they have been part of the solution.
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
California's Office of the Attorney General contends that drugmakers and pharmacy benefit managers work together to “aggressively raise the list price of insulin in lockstep with each other to artificial levels.” Insulin manufacturers deny the allegations, pointing to availability of lower-cost versions of their products.
Large employers, particularly self-insured companies, can demand a better and fairer system. They can use their contracting power to insist that their plans cover all FDA approved drugs.
Confidentiality agreements typically prevent the public from obtaining a window into the cases against pharmacy behemoths but a public court filing makes this one different.
CVS Caremark recently launched efforts to better prevent, detect and treat sickle cell disease, HIV and cardiovascular disease. CVS Caremark CMO Sree Chaguturu shared how the PBM launched this effort at the engagement track at HLTH, hosted by MedCity News
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The conference will include conversations with healthcare industry experts from The Steve & Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Vineti, Ori Biotech, CVS Caremark, Caris Life Sciences, HHS, University City Science Center, and more.
CVS Caremark added five new companies to its Point Solution Management Service, which it launched last year to make it easier for businesses to implement digital health tools. CVS Caremark CMO Sree Chaguturu shared more about the PBM’s plans for digital health.
The company's first vendor partner on the system is San Francisco-based Big Health, which is offering its digital CBT-based sleep improvement program Sleepio through the service.
Anthem, which has nearly 40 million members, has moved up the timeline on the development and launch of its own PBM known as IngenioRx, cutting ties with Express Scripts in the process.
The contract dispute will affect Walmart's commercial and Managed Medicaid retail pharmacy patients.
