Pharmacy benefit managers are under scrutiny for their business practices that are often blamed for contributing to the rising costs of prescription drugs in America. But one PBM is paving another way that alters the traditional operating model.
The U.K. cost-effectiveness standard for drugs will increase by 25% in exchange for zero tariffs on the country’s pharmaceutical exports. The new trade agreement’s parameters could shape deals the Trump administration is pursuing with other countries.
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
The 340B Drug Pricing Program was designed to help safety net providers serve low-income patients, but it has since ballooned into a multibillion-dollar system dominated by large health systems — with a major lack of transparency about how savings are used to benefit patients. As HRSA launches a new rebate-based model meant to boost oversight, experts warned that it could instead burden smaller providers and fail to address the program’s deeper flaws.
Newly launched Pfizer drugs will be priced at parity to prices in comparable developed nations, according to the most-favored nation pricing agreement. But industry observers note that big pharma companies are also raising some prices overseas as part of a strategy to protect U.S. revenue.
Bristol Myers Squibb plaque psoriasis drug Sotyktu will be the first product available at a steep discount to eligible cash-pay patients who use BMS Patient Connect, a new online platform set to launch in January. Direct-to-patient sales could offer one way for pharma companies to address President Trump’s call for lower drug prices.
Every day, patients are making agonizing choices to skip medications due to cost, and the fallout is evident in worsening health and avoidable hospitalizations. Health systems are in a prime position to break this cycle by acting as advocates for their patients’ financial as well as physical well-being.
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
UH Group replaces its CEO, the payer's alleged nursing home practices, the future of pharmacy benefit managers, and the healthcare implications of the budget bill are part of the latest episode of the Debunked Podcast with MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, managing partner of Health Innovation Pitch.
President Trump’s executive order provides a framework for tying the prices of U.S. pharmaceutical products to the lower prices paid in other countries, what’s called most-favored-nation pricing. If drug companies do not lower their prices accordingly, the order proposes other strategies, such as importing drugs from other countries.
Metabolic medicines dominated life sciences headlines in 2024, a trend expected to continue into the new year. Other things to look for include more widespread adoption of artificial intelligence technologies and the IPO market’s return to normal levels.
Senators Elizabeth Warren and Josh Hawley and Representatives Diana Harshbarger and Jake Auchincloss introduced the Patients Before Monopolies Act on Wednesday. It aims to prohibit the parent company of a PBM or insurer from owning a pharmacy business.
AI-native tax firm Gelt combines top human tax experts with AI to help physicians and healthcare practices use data-driven tax strategies to lower liabilities, improve profitability, and future-proof their finances.
Any successful response to skyrocketing drug costs has to also actively manage medications at the individual level — just because someone can be on a medication doesn’t mean they should be.
It is crucial that we preserve the unique public-private partnership framework that drives innovation in our country by ensuring that the Bayh-Dole Act remains intact.
Season 2 of the MedCity Pivot Podcast has launched with a special focus on the evolution of pharmacy and pharmacy benefit management. The first guest this season is A.J. Loiacono, who leads Capital Rx.
A federal judge disagreed with AstraZeneca’s claims that the Inflation Reduction Act causes harm by disincentivizing innovation and violates its constitutional rights to due process. Blockbuster AstraZeneca drug Farxiga is one of 10 medications selected for the Medicare drug price negotiation program created by the law.
Merith Basey, executive director of Patients For Affordable Drugs, believes the Medicare price negotiation program is here to stay, no matter who is president and no matter how many Big Pharma players file lawsuits. Her reasoning? Every other high income nation has been negotiating prices with drugmakers for years, and the program is widely popular in the U.S. among pretty much everyone who isn’t a pharma company, she said during a session at Engage at HLTH.