After the FTC filed a lawsuit in September, accusing the three major pharmacy benefit managers of anticompetitive rebating practices related to insulin, the defendants reversed roles and became plaintiffs. In November, they countersued the agency, arguing that its lawsuit is unconstitutional.
What concrete strategies should employers pursue to control rising costs while ensuring the best member experience and clinical outcomes?
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
HealthJoy and Mark Cuban Cost Plus Drug Company have teamed up. Through the partnership, HealthJoy can now direct the employees of its clients to the drug company when it offers a cheaper option for generic drugs.
The White House might soon finalize a rule that will either save or cost patients billions of dollars in prescription drug costs. The rule concerns “copay accumulators,” which are programs health plans use to prevent copay assistance from counting toward patients’ deductibles or out-of-pocket maximums.
A bipartisan group of senators sent a letter to HHS asking it to rethink its appeal of a recent federal district court decision that limits the use of “copay accumulators" — which are programs insurers use to prevent medication copay assistance from counting toward patients’ deductibles or out-of-pocket maximums.
Executives at LRVHealth expect to see a continued focus on generative AI, increased enrollment in Medicare Advantage and more in 2024.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
Hospitals’ pharmacy spending is projected to rise by 3.42% next year, according to a new report. Specialty drugs, including Ozempic and Humira, as well as neurology medications are the primary drivers of this increase in pharmacy expenses.
New research predicts that healthcare costs will increase by 7% next year. The estimate is higher than the projected medical cost trends in 2022 and 2023 — which were 5.5% and 6.0%, respectively.
The National Alliance of Healthcare Purchaser Coalitions released a playbook on Monday that outlines the key concerns employers have about pharmacy benefit management, and provides several recommendations for employers.
A recent CDC report found that many Americans are not taking their prescription medications as directed to reduce costs. There are significant differences in Americans doing so based on gender, race and coverage.
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
Express Scripts released several new solutions last week that aim to improve drug price transparency, including a cap on out-of-pocket costs for prescription drugs for consumers. The news comes amid increasing scrutiny against pharmacy benefit managers.
Zócalo Health, a virtual primary care provider designed for Latino patients, recently forged a collaboration with Mark Cuban's Cost Plus Drugs. Now all Zócalo patients have access to Cost Plus Drugs’ prescriptions, and the provider's community health workers have been trained to help walk patients through the process of obtaining medications through the pharmacy.
For the first time ever, CMS is preparing to negotiate prices for drugs paid for by Medicare. This has sparked a huge debate — will the creation of this taxpayer-funded drug negotiation infrastructure be a failed experiment, or will it become the standard for the future of drug pricing in this country? Jason Borschow, president and CEO of Abarca Health, says it's the latter.
Panelists at a recent pharmacy conference were optimistic about the future of value-based drug contracting. For example, one said that healthcare will be close to establishing a value-based formulary by 2030, and another said that longitudinal patient tracking will become a more important part the drug pricing process.
The Senate Commerce Committee held a hearing Thursday, which discussed how the Pharmacy Benefit Manager Transparency Act would affect practices by pharmacy benefit managers, including clawbacks. Some questioned why PBMs are even necessary.