prescription drug costs

The 340B Program’s New Rebate Pilot Won’t Fix Its Problems

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.

By Katie Adams

Consumer / Employer, Payers

Cigna’s Rebate-Free Model Sounds Nice, But Experts Are Still Skeptical

As lawmakers consider stricter PBM regulation, Cigna launched a “rebate-free” model to give patients upfront drug discounts, but experts question whether it will lead to meaningful change.

By Marissa Plescia

Health Tech

5 Healthcare Predictions for 2025 from One VC Firm

Healthcare experts should be on the lookout for trends related to digital health, prescription drug costs and healthcare coverage in 2025, according to LRVHealth.

By Marissa Plescia

MedCity Influencers

The Cost of Medication Non-Adherence — How Hospitals Can Close the Gap through Better Communication

You can provide the best care possible inside the four walls of your hospital, but if your patients can’t afford their prescriptions after you discharge them, the system isn’t working.

By Joy Avery

Payers, Providers

AMA Report Details Low Competition in PBM Market

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.

By Marissa Plescia

BioPharma, Legal, Pharmacy

An Upcoming White House Decision May Jeopardize Americans’ Access to Life-Saving Drugs

The White House might soon finalize a rule that will either save or cost patients billions of dollars in prescription drug costs. The rule concerns “copay accumulators,” which are programs health plans use to prevent copay assistance from counting toward patients’ deductibles or out-of-pocket maximums.

By Katie Adams

Payers, Consumer / Employer

Who Is Responsible for the High Cost of Prescription Drugs? One Advocate Weighs In

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.

By Marissa Plescia

Consumer / Employer, Legal

4 Healthcare Takeaways from Biden’s State of the Union Address

President Joe Biden discussed several healthcare concerns during his State of the Union address, including reproductive rights, prescription drug costs, the Affordable Care Act and women's health research.

By Marissa Plescia

Payers

Blue Shield of California CEO on PBM Shakeup: ‘It’s Going to Become the Norm’

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.

By Marissa Plescia

Health Tech

Elation Health’s New Integration Brings Drug Pricing Transparency to the Point of Care for PCPs

Elation Health integrated Surescripts’ real-time prescription benefit tool — which gives clinicians immediate access to patient-specific medication coverage and cost data — into its EHR. The partnership aims to improve patients' medication adherence by helping primary care physicians have more meaningful conversations with their patients about prescription affordability during visits.

By Katie Adams

Consumer / Employer, Payers

Medicaid Spending on Prescriptions Has Risen Despite Lower Utilization

A new KFF report analyzed recent trends in Medicaid outpatient prescription drug utilization and spending. It discovered that although there's been lower utilization of prescription drugs in recent years, Medicaid spending on prescription drugs has increased.

By Marissa Plescia

Consumer / Employer, Legal

Bipartisan Price Transparency Bill Passes in House

The Lower Costs, More Transparency Act has passed in the House with bipartisan support. The action is being applauded from several advocacy organizations.

By Marissa Plescia

Consumer / Employer

Walgreens Unveils Tool To Help Patients Save on Prescriptions

The Walgreens Rx Savings Finder combines different third-party discount card options into one platform. It allows customers to search for a prescription, find a coupon for that prescription and text or email the coupon to themselves. They then show the coupon to a Walgreens pharmacist when they fill the prescription.

By Marissa Plescia

Consumer / Employer

CVS Exec: We’re Going To Find Out if Blue Shield of California’s New Drug Model Will Lower Costs

Blue Shield of California recently switched up its pharmacy benefit model by distributing responsibilities to several different vendors. The model has the potential to increase drug costs, but it remains to be seen, according to Creagh Milford, SVP of retail health at CVS Health.

By Marissa Plescia

Consumer / Employer, BioPharma, Legal

HHS Drops First 10 Drugs for Medicare Drug Price Negotiation

HHS released the first 10 drugs selected for the Medicare Drug Price Negotiation Program. These drugs include Eliquis, Jardiance and Xarelto. Under the program, the federal government will be able to negotiate the price for selected drugs for the first time.

By Marissa Plescia