As of July 1, a Florida bill increases oversight of pharmacy benefit managers and offers some protection for pharmacies. However, the legislation has limited effects on patients and providers, highlighting the need for additional reform.
Search results for: pharmacy benefit managers
Landmark Supreme Court Decision Supports States’ Rights to Regulate Pharmacy Benefit Managers
On Dec. 10, the Supreme Court of the United States of America (SCOTUS) issued a landmark decision in Rutledge, Attorney General of Arkansas, v. Pharmaceutical Care Management Association. In an 8–0 decision, the justices agreed that states have the right to impose regulations on pharmacy benefit managers (PBMs), companies that manage prescription drug benefits on…
Kentucky Launches Probe into Drug Overcharges by Pharmacy Benefit Managers
(Reuters)—Kentucky Attorney General Andy Beshear said on Thursday he had launched an investigation into allegations that pharmacy benefit managers (PBMs) had overcharged state health insurance programs for drugs and discriminated against independent pharmacies. The investigation comes against the backdrop of widespread criticism of rising costs of prescription medicines in the United States, with PBMs, middlemen…
Rheumatologists Air Frustrations with Pharmacy Benefit Managers at Annual Meeting
SAN DIEGO—Pharmacy benefit managers (PBMs) and their impact on drug prices and access to high-cost medications by the patients rheumatologists treat was a major theme at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. In one session, industry experts tried to clarify the role for prior authorizations and drug formulary policies and explored ways to constructively…
U.S. Probes Contracts Between Drugmakers, Pharmacy Benefit Managers
(Reuters)—The U.S. Attorney’s Office for the Southern District of New York is investigating contracts between drugmakers and companies that manage prescription benefits, according to regulatory filings. Federal prosecutors have approached at least three companies, including Johnson & Johnson, Merck & Co. and Endo International Plc., demanding information about their contracts with pharmacy benefit managers. Pharmacy…
ACR Leads AMA Resolution to Address Disruptive Practices of Pharmacy Benefit Administrators
At the AMA House of Delegates meeting in November, the ACR’s delegation will lead over a dozen cosponsoring specialties and medical associations in advancing a resolution addressing serious concerns about third-party pharmacy benefit administrators and the impacts of their disruptive practices.
Health Insurer Anthem Takes Pharmacy Business in House, Taps CVS to Help
(Reuters)—Health insurer Anthem Inc will start managing its billions of dollars of patient prescriptions itself in 2020, it said on Wednesday, ending a deal with Express Scripts Holding that had deteriorated into lawsuits over terms. Anthem, which sued the pharmacy benefit manager last year over claims of being overcharged by $3 billion annually, said it…
Novartis to Pay $390 Million in U.S. Settlement over Pharmacy Kickbacks
WASHINGTON (Reuters)—Novartis Pharmaceuticals Corp. will pay $390 million to settle U.S. charges that it paid specialty pharmacies illegal kickbacks in exchange for inducing patients to refill certain medications, according to an accord announced Friday. The settlement between a U.S. unit of Swiss drugmaker Novartis AG, the federal government and more than 40 states concerns payments…
U.S. Drug Benefit Managers Clamp Down on Specialty Pharmacies
NEW YORK/LOS ANGELES (Reuters)—In recent days, the largest U.S. managers of private prescription drug benefits have cut off at least eight pharmacies that work closely with drugmakers, intensifying scrutiny of a system that helps inflate drug prices, officials at the benefit managers told Reuters. The terminations come from payers who together manage drug benefits for…
Experts Highlight Key Issues Impairing Access to Care
Speakers discussed common payer practices and policies that rheumatologists must navigate to secure and maintain appropriate care for their patients, including pharmacy benefit managers and prior authorization.
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