The Ohio attorney general has filed a lawsuit alleging that a Centene subsidiary, which provides Medicaid services in the state, hired multiple companies to administer pharmacy benefits in order to inflate costs. As a result, the state's Medicaid department paid millions in overcharges.
To reduce drug prices, we should focus on the complex drug channel arrangements that stand between manufacturers and patients and not as much on price controls.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
WithMe Health, a startup trying to build a new approach to pharmacy benefits, spun off a medication guidance service that can be layer on top of existing PBMs. It also raised $20 million in funding, led by OMERS Ventures.
Opioid overutilization is a public health crisis, and PBMs with programs aimed at curbing abuse and educating providers can have a positive and substantial impact on clients and their members.
The startup's CEO believes tha prescription drug pricing is needlessly complex and real-time data analytics that his company has developed for pharmacy benefits managers to lower employers' drug spending is going to shift the dynamics in the industry.
The Washington Post and other outlets reported that the administration has withdrawn a proposal to end rebates between pharmacy benefit managers and drugmakers.
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 proposed rule, which will be officially published on Wednesday, is part of the Trump administration's blueprint for reducing out-of-pocket drug prices. However, others have said it could raise premiums and have doubted how much power the administration truly has.
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.
The company emphasized that the increases mostly amount to 3-5 percent and affect only 10 percent of its portfolio, but declined to reveal which drugs are affected.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
In a position statement, ASCO said PBM practices can result in medication dispensing errors, harm physicians' ability to treat patients and drive up costs.
Transparency in pricing negotiations is key to ensuring costs are brought down, experts say, pointing to state-level legislation to mandate it.
Approval for the deal - which still needs antitrust regulators' blessing - comes months after shareholders approved CVS-Aetna merger.
Value-based drug pricing appears to be on the horizon, but there are multiple possibilities for how it will be implemented, expert says.
Transformation is a strong undercurrent in healthcare these days. Online retailer Amazon and insurer Anthem want to be in the pharmacy benefit management business and drugstore retailer CVS Health wants to be an insurer, too.