PBMs

Orphan Drug Relief Still In Budget Bill But Uncertainty Remains

 
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The budget reconciliation bill nears final passage without pharmacy benefit manager reforms or provisions that would facilitate access to cell and gene therapies for children, but its Medicaid cuts pose a significant threat to prescription drug access.

Oz Says Big PBMs Have ‘Window’ to Quit Rebate System on Their Own

 
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CMS Administrator Mehmet Oz said PBMs may deserve "one last chance" to fix the rebate system before federal regulations and legislation are enacted.

PCMA, CVS, Cigna File Lawsuits Over ‘Dangerous’ Arkansas PBM Law

 
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The suits are an early test of the Arkansas law banning company ownership of PBMs and pharmacies in the state, as other states consider similar legislation.

PBM Investigation, Enforcement Action ‘Critical Priorities’ At FTC, Chair Says

 
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The new FTC chair addressed concerns that staffing cuts will undermine the commission’s commitment to pharmacy benefit manager oversight.


‘Tectonic’ Arkansas PBM Legislation May Upend Industry

 
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Industry will fight hard to prevent other states or the federal government from adopting measures similar to Arkansas' law preventing PBMs from owning pharmacies.

House Budget Bill Includes Delayed Orphan Fix, Also Risks Downstream Cell and Gene Coverage

 

The first two classes of negotiated drugs under the Inflation Reduction Act would not benefit from a rare disease adjustment House Republicans included in their reconciliation package.

PBMs No Longer Profit From Rebates But Plans Benefit; Should Sponsors Push More For Reform?

 
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Employers and other health plan sponsors may need to push for better targeted reforms that lower cost sharing for patients.

PBMs Must Prepare For Revival Of Drug Price Transparency Requirements

 

Experts say PBMs should become familiar with transparency rules and prepare to release data, although more legal wrangling could occur.


Is Optum Rx Payment Remodel To Favor Generics A Peace Offering For US FTC?

 

Optum Rx, one of the largest PBMs in the US, declared it was the “first comprehensive, transparent pharmacy services company” after announcing several consumer-friendly changes.

Study Shows ‘Insurer-PBMs’ Dominate Medicare Part D, Steer Patients to Their Pharmacies

 
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An analysis of Medicare Part D and other data found that more than one-third of all pharmacy spending went through pharmacies owned by Cigna, CVS Health, Humana or UnitedHealth Group.

PBM Reform Legislation Do-Over Will Need Bipartisan Help Amid Partisan Budget Battle

 
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The leader of the House Energy and Commerce Health Subcommittee has a plan for passing pharmacy benefit manager reforms, but Democrats are skeptical.

PhRMA Still All In For Trump Despite Chaos Hitting US Health Sector

 

The pharmaceutical industry has been quiet on Trump's early federal government overhauls that could harm the drug business, still betting he will help produce better results than Biden.


Incoming US FTC Chair Endorses Agency Report Challenging PBM Generic Drug Markups

 
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Chairman-designee Andrew Ferguson likely will continue the commission’s investigation of PBMs during the next administration.

This Year, PBM-Directed Fury May Once Again Signify Nothing

 
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Anti-PBM sentiment continues to rise, but industry observers still question whether the reforms being discussed will be effective.

US Government Keeps Lights On But Pharma Priorities For PBM Reform, Rare Diseases Nixed

 

The FDA will stay open, but its rare disease priority review voucher program will wind down after not being renewed on 20 December. PBM reform and other industry priorities also were nixed at the last minute in an effort to avoid a government shutdown.

Chink In PBM Armor? ‘Delinking’ Policy In Spending Bill But Passage Unclear

 
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Delinking policy, a reform long-sought by pharma, was included in proposed must-pass government funding legislation that was teetering on collapse.


Health Care Industry Shaken After UnitedHealthcare CEO Is Killed Outside NYC Hotel

 
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The motive for the shocking murder of Brian Thompson in New York City was still unknown Wednesday afternoon.

Would Red or Blue Election Wins Be Better for PBMs? It’s a Tossup

 
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PBM reform likely will remain a priority no matter which party controls Congress, but experts differ on the party that likely would be harder on the industry.

PBMs, FTC and IRA: Experts Tackle Pharma’s Tough Acronyms At BioFuture Conference

 

Some of the industry’s biggest challenges, and potential solutions, were hot topics at the BioFuture conference in New York.

Mileage of FTC Suit Against PBMs May Vary, Experts Suggest

 
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With a single drug category and an uncertain political future, the FTC’s legal efforts may gain limited traction. Was focusing on insulin rebating a wisely targeted approach or did the case underemphasize the ‘emotionally more powerful consumer deception issue’?