The Prescription Drug Problem & PBM Reform
June 25, 2024
New York Times puts pharmacy benefit managers on the front pageReporters have accused PBMs of steering patients toward more expensive drugs and extracting hidden fees.
June 27, 2024
U.S. states with the highest prescription drug spendAccording to a new study, from January 2022 to January 2023, an average price increase of $590 occurred for more than 4,200 drugs.
June 27, 2024
Medicare to get rebates for 64 prescription drugsThe government plans to bill the drugmakers for the rebates by late 2025, as part of the new Inflation Reduction Act requirement.
June 28, 2024
House Committee advances bill to expand Medicare coverage of obesity drugsThe Treat and Reduce Obesity Act provides coverage for patients who had an insurance plan that covered the new weight loss drugs, like Wegovy and Ozempic, before they entered Medicare.
July 02, 2024
Some health plans push patients toward specialty drug charities on purposeLisa Gomez, EBSA's chief, testified at a House hearing that the Labor Department has the statutory authority to stop that.
July 03, 2024
Maryland could cap prices for Ozempic and other diabetes drugsA state board picked those products and two others for reviews that could lead to "upper payment limits."
July 08, 2024
Mail-order pharmacies add much bigger markups: Washington state groupsFor brand-name drugs, the average margin gap may be more than $65 per 30-day prescription.
July 10, 2024
FTC staff objects to big PBMs' 'outsized influence' in interim reportOne commissioner voted against release, saying the report lacks "economic rigor expected of Commission reports."
July 22, 2024
Plan sponsors saving on prescription drugs amidst rising costs and inflationAccording to the report, new clients realized an average of 11% reduction in costs compared to the previous year, with a different PBM.
July 22, 2024
PharMerica settles False Claims Act suit for $100M over alleged drug kickback scheme"We believed in our case, and that is why we committed so many resources to litigating it. And in the end, you know, I believe that we got a very excellent result," said Sherrie R. Savett of Berger Montague, who represented the plaintiff.