Pharmacy Benefit Managers

Exploring Transparency-Rx’s pharmacy benefit manager partners

March 18, 2024 - Transparency-Rx is a recently launched organization of transparent pharmacy benefit managers working towards addressing the ongoing challenges with pharmacy benefit managers (PBMs) that have hindered access to care and significantly increased healthcare spending. “We just launched in September last year as a formal business coalition. Our goal is really to highlight to Congress...

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Senate Hearing Challenges Pharma CEOs on Drug Pricing

by Alivia Kaylor

In a heated Senate hearing on February 8th, the CEOs of Bristol Myers Squibb, Johnson & Johnson, and Merck faced rigorous questioning from various United States senators regarding the exorbitant...

US States, Cities Sue Insulin Makers Over Shortages, High Prices

by Alivia Kaylor

In recent weeks, a wave of lawsuits has emerged as more states and cities in the United States take legal action against insulin makers and pharmacy benefit managers (PBMs). These lawsuits allege that...

Exploring Pharmacy Benefit Manager Reforms: Transparency

by Veronica Salib

Pharmacy benefit managers (PBMs) have received criticism over the past couple of years for pocketing savings intended for patients. While this rhetoric is true for some PBMs, a small subset of the market advocates for PBM transparency and...

FTC’s Lawsuit Against Amgen Horizon Deal to Reach Court in September

by Hayden Schmidt

Federal Trade Commission (FTC) officials are taking Amgen and Horizon to court this September to block a prospective pharmaceutical acquisition of the two companies. The FTC announced that it planned...

Ohio Attorney General Sues Pharmacy Benefit Managers Due to Collusion

by Veronica Salib

On Monday, March 27, 2023, Ohio Attorney General Dave Yost sued pharmacy benefit managers (PBMs) from multiple organizations for collusion on drug prices. The lawsuit names numerous defendants,...

Fundamentals of the Pharmaceutical Supply Chain

by Alivia Kaylor

The pharmaceutical supply chain poses risks and challenges to both providers and consumers. But in the context of a health-conscious society, managing pharmaceutical supply chains presents several...

Pharmacists Are Excluded in Burnout Conversations

by Veronica Salib

Throughout the COVID-19 pandemic, many experts, industry leaders, and public health officials discussed workplace burnout and its effects on the healthcare industry. The discussion centered on physicians and nurses who saw unprecedented...

AMA Analysis Finds Variations in PBM Competition

by Veronica Salib

In a recent analysis written by José R. Guardado, PhD, for the AMA, he analyzed the competition against drug intermediaries, referred to as pharmacy benefit managers (PBMs). In the report,...

Kroger Health to End Express Scripts Pharmacy Provider Agreement

by Hayden Schmidt

Last week, Kroger Health — the grocery store chain’s pharmacy business — surprised Express Scripts with written notice of intention to terminate their agreement for commercial...

NCQA Program Supports Best Practices in Specialty Pharmacy

by Samantha McGrail

NCQA recently launched Specialty Pharmacy Accreditation, a service to help discern quality leaders and support value-based contracting in specialty pharmacy.  Specialty Pharmacy Accreditation...

8 Companies Claim CVS Health Overcharged for Prescription Drugs

by Samantha McGrail

Several companies are filing a lawsuit against CVS Health, claiming that the retail pharmacy chain intentionally overcharged plaintiffs for prescription drugs by submitting claims for payment at...

CVS Caremark Prescription Drug Trend Rose to 2.9% in 2020

by Samantha McGrail

CVS Caremark recently announced that its overall prescription drug trend for 2020 was 2.9 percent, while there was a negative trend for 34 percent of commercial pharmacy benefit management (PBM)...

CVS Works to Improve Drug Affordability, Accessibility

by Samantha McGrail

Although the treatment prescribed to a patient by a doctor should be best tailored and personalized to the individual, drug affordability and access continues to be a challenge for patients in the...

Supreme Court Allows States to Regulate Pharmacy Benefit Managers

by Samantha McGrail

The Supreme Court unanimously ruled that US states can regulate pharmacy benefit managers.  The decision released at the beginning of December ruled in favor of groups arguing on behalf of...

Trump Aims to Lower Drug Prices Via PBM Reform, Drug Importation

by Samantha McGrail

The Trump administration is aiming to lower drug prices by eliminating kickbacks to middlemen, like pharmacy benefit managers (PBMs), and increasing drug importation in three new executive orders...

PBM Reimbursement Significantly Varies for Generic Drugs

by Samantha McGrail

Pharmacy benefit manager (PBM) reimbursement for generic drugs significantly varies by medication and plan, and does not respond to price hikes, according to a study from 3 Axis Advisors. Researchers...

CVS Caremark Implements Measures to Protect COVID-19 Supply Chain

by Samantha McGrail

CVS Caremark, the pharmacy benefit manager business of CVS Health, recently announced that it is working with clients to implement new measures to protect and strengthen the COVID-19 supply chain,...

Pharmacy Benefit Managers Prepared to Tackle COVID-19

by Samantha McGrail

Pharmaceutical Care Management Association (PCMA) president and CEO JC Scott issued a letter to the Trump Administration’s COVID-19 Task Force affirming pharmacy benefit managers’ (PBMs)...

Policymakers Call Out Express Scripts Over Rising Insulin Prices

by Samantha McGrail

Two members of the United States Committee on Finance made a final document request to pharmacy benefit manager Express Scripts, owned by Cigna, and warned that failure to comply will result in a...

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