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Search results for: pharmacy benefit managers

Pharmacy Benefit Managers Under Scrutiny

Elizabeth Hofheinz, MPH, MEd  |  June 10, 2024

“When pharmacy benefit managers [PBMs] came into being 30 years ago, they were seen as an important component of the prescription distribution system [because] they could guide benefits and money between the patient, pharmacy and the manufacturer,” says Angus Worthing, MD, president of the Alliance for Transparent & Affordable Prescriptions (ATAP). Health insurance companies hire…

Filed under:Drug UpdatesLegislation & Advocacy Tagged with:drug pricingdrug pricing transparencypharmacy benefit managers (PBMs)

Florida Law Puts Drug Pricing by Pharmacy Benefit Managers Under a Microscope Once Again

Catherine Kolonko  |  August 8, 2022

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.

Filed under:Legislation & Advocacy Tagged with:Floridapharmacy benefit managers (PBMs)state legislation

Landmark Supreme Court Decision Supports States’ Rights to Regulate Pharmacy Benefit Managers

Keri Losavio  |  December 16, 2020

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…

Filed under:American College of RheumatologyPractice Support Tagged with:Alliance for Transparent & Affordable Prescriptions (ATAP)pharmacy benefit managers (PBMs)U.S. Supreme Court

Kentucky Launches Probe into Drug Overcharges by Pharmacy Benefit Managers

Reuters Staff  |  March 25, 2019

(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…

Filed under:Legal Updates Tagged with:Kentucky PBM probepharmacy benefit managers (PBMs)rising U.S. drug costs

Rheumatologists Air Frustrations with Pharmacy Benefit Managers at Annual Meeting

Larry Beresford  |  January 19, 2018

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…

Filed under:Drug UpdatesLegislation & AdvocacyMeeting ReportsProfessional Topics Tagged with:ACR/ARHP Annual MeetingAdvocacydrugpharmacy benefit managers (PBMs)

U.S. Probes Contracts Between Drugmakers, Pharmacy Benefit Managers

Reuters Staff  |  May 11, 2016

(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…

Filed under:Drug Updates Tagged with:costsdrugdrug developmentLegalpharmaceutical companypharmacy

Arkansas Leads the Nation with Landmark Pharmacy Benefit Manager Reform

Joseph Cantrell, JD  |  June 22, 2025

Signed into law in April, the legislation will ban direct and indirect PBM ownership of pharmacies, effective Jan. 1, 2026. It addresses longstanding concerns about conflicts of interest, market consolidation and patient access created by vertically integrated PBM pharmacy models.

Filed under:Legal UpdatesLegislation & Advocacy Tagged with:pharmacy benefit managers (PBMs)state legislation

ACR Leads AMA Resolution to Address Disruptive Practices of Pharmacy Benefit Administrators

From the College  |  October 24, 2022

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.

Filed under:Legislation & Advocacy Tagged with:AMA House of Delegates (HOD)House of Delegates interim meetingpharmacy benefit administratorspharmacy benefit managers (PBMs)

Health Insurer Anthem Takes Pharmacy Business in House, Taps CVS to Help

Reuters Staff  |  October 18, 2017

(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…

Filed under:Uncategorized Tagged with:Anthem Inc.Express Scripts Holdingin-house pharmacy businesspharmacy benefit managers (PBMs)

Novartis to Pay $390 Million in U.S. Settlement over Pharmacy Kickbacks

Sarah N. Lynch  |  November 24, 2015

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…

Filed under:Drug Updates Tagged with:False Claims ActfraudLegalNovartispharmacy

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