A judge recently blocked an Arkansas law that would have banned PBMs from owning and operating pharmacies in the state. Although the state plans to appeal, one expert says the law likely has no future.
Arkansas became the first state to pass a law banning pharmacy benefit managers from owning pharmacies, aiming to curb their market power and reduce drug costs. But major PBMs like CVS and Express Scripts are suing, claiming the law is unconstitutional.
At a time when AI is reshaping pharma, Reverba Global CEO Cheryl Lubbert explained in an interview why empathy, context, and ethics still require a human touch.
On Tuesday, the Federal Trade Commission released its second interim staff report on prescription drug middlemen. The report examines the impact of PBMs (specifically CVS Caremark, Express Scripts and Optum Rx) on specialty generic drugs, highlighting substantial price markups by PBMs on medications for cancer, HIV and other conditions.
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.
The Federal Trade Commission has sued CVS Caremark, Express Scripts and Optum Rx, alleging that they engage in "anticompetitive and unfair rebating practices” as it relates to insulin. One legal expert believes the FTC might win this legal battle.
Multiple stakeholders are to blame for prescription drug costs, including pharmaceutical companies and PBMs, according to Merith Basey, executive director of Patients for Affordable Drugs.
Explore top-tier aesthetic certification programs that blend theory with hands-on training — perfect for health care pros ready to elevate their practice
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.
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.
Here is a selection of recent executive hires, departures and layoffs occurring across the healthcare industry.
Requiring that PBMs bid on a per member per month guarantee would reduce the employer’s uncertainty by securing the actual per member per month cost to the employer.
Neurologists and health care practitioners must evolve with the world. Telemedicine carts assist in this evolution by serving as an intermediary between patients and doctors.
Following an investigation, the AG claimed Express Scripts, “billed and obtained payment for prescription drugs from payers of workers' compensation claims in excess of amounts permitted by Massachusetts laws and regulations,” according to court documents.
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.
Centene is swapping CVS Caremark with Express Scripts. A recent survey that measured benefit leaders' satisfaction with their PBMs found that Express Scripts performed better than CVS Caremark.
The company is rolling out an app for users to show proof of vaccination using a QR code. It can automatically pull in vaccine records for people whose health plans use Express Scripts and who got vaccinated at a pharmacy.
Some healthcare startups that offer at-home prescription deliveries and test kits have experienced delays with the USPS. They shared how they're navigating the changes.