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.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
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The Washington Post and other outlets reported that the administration has withdrawn a proposal to end rebates between pharmacy benefit managers and drugmakers.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 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.
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
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.
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.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
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.
Anthem has signed a five-year contract with CVS Health to establish the pharmacy benefit management company, which will begin offering services in 2020.
The case alleges that insured workers paid too much because Express Scripts charged “above competitive pricing levels” and Anthem, in effect, allowed those higher prices as part of a 10-year contract deal with the PBM, in violation of ERISA.