Congress released a stopgap funding bill with a significant healthcare package, and provider groups are reacting favorably. They are mainly applauding provisions that reign in PBMs’ business practices, extend telehealth flexibilities, and boost payments to hospitals and physicians.
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.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
Experts agree that the incoming Trump administration will likely shake things up in the prescription drug world — most notably when it comes to research and development, drug pricing and PBM reform.
How are employers tackling the current landscape of healthcare costs? We turned to Shawn Gremminger, CEO of the National Alliance of Healthcare Purchaser Coalitions, a group of regional coalitions representing self-insured employers large and small that cover roughly 40 million people.
Months before the FTC sued the three largest pharmacy benefit managers, the CEO of Blue Shield of California battled its PBM - CVS Caremark - to bring a lower cost prostate cancer drug to its members.
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.
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
The American Medical Association released a new report on Monday on pharmacy benefit managers. It explained that there is low competition among PBMs and high vertical integration with payers.
Losing these retail medication outlets creates more than just pharmacy deserts. In many low-income and underserved areas, drugstores also serve as grocery stores and hubs for essential services, and hence their closures mean communities lose crucial access points for a variety of goods and services.
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.
We can’t wait for others to find a solution to high drug prices. It’s clear what should happen in a functioning drug pricing market federally and in California, but it is not happening today.
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.
The Federal Trade Commission recently released an interim report that details how the practices of pharmacy benefit managers negatively impact patients and pharmacies. Some experts hope for legislative action based on the report.
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.
We must realign the financial incentives and democratize access through data sharing. Pharma needs to lead the charge, but employers and pharmacies must also be agents of change. Here’s how we can do it.
Through a new strategic alliance, Prime Therapeutics will be the only PBM — aside from Capital Rx — to use Capital Rx’s JUDI platform.
During a fireside chat hosted by MedCity News at ViVE, Blue Shield of California CEO Paul Markovich discussed the company's decision to largely move away from CVS Caremark as its PBM and partner with several other companies.