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We Can’t Have Lower Insurance Premiums and Drug Costs Without Reforming PBMs

We Can’t Have Lower Insurance Premiums and Drug Costs Without Reforming PBMs

We Can’t Have Lower Insurance Premiums and Drug Costs Without Reforming PBMs

DC Journal Author: Mark Merritt If Americans want to pay less for prescription drugs, there is no way to do it without reforming the Pharmacy Benefit Manager industry. Congress should do so by the end of this year. The PBMs, once known for reducing drug costs, no longer exist. Literally, they are no longer independent companies. They sit inside the insurance giants that own them. Cash machines to help health conglomerates hit quarterly numbers. For 15 years, I led the trade a

1 min read

Express Scripts is overcharging taxpayers billions of dollars through TRICARE

Express Scripts is overcharging taxpayers billions of dollars through TRICARE

How A Pharma Giant Is Looting The Pentagon

The drug intermediary overseeing the military’s TRICARE pharmacy program is limiting access to care and overcharging taxpayers hundreds of dollars on average per prescription. The Lever Reporter: Helen Santoro One of the nation’s most powerful pharmacy intermediaries is quietly charging the military’s health insurance program $484 more on average per generic drug than independent and big chain pharmacies, according to exclusive data shared with The Lever. The scheme forces ta

Pharmacy Patients

3 min read

The U.S. experiment with profit-driven health care has failed

The U.S. experiment with profit-driven health care has failed

The U.S. experiment with profit-driven health care has failed

The corporate takeover of health care has destroyed America’s health STAT Reporters: Steffie Woolhandler, David U. Himmelstein, Adam W. Gaffney, and Danny McCormick Health care costs are surging. ACA Marketplace premiums will rise 18% next year— even more for the millions set to lose their enhanced federal subsidies without congressional action. Meanwhile, big employers expect their premiums — already about $25,000 for family coverage — to increase 9% in 2026. Gargantuan he

3 min read

Congress Must Pass PBM Reform

Congress Must Pass PBM Reform

To Lower Prescription Costs, Policymakers Must Keep Their Eyes on the Prize - Inside Sources

Prescott eNews At the speed of today’s news cycle, it can be hard to keep up with the latest healthcare policy news coming out of...

1 min read

PBM reform legislation

PBM reform legislation

Drug price reform: 5 state-level bills and their potential national impacts

BenefitsPro Reporter: Wes Hill Whether it is regulating pharmaceutical manufacturers, health insurers, or pharmacy benefits managers,...

3 min read

State PBM reform efforts

State PBM reform efforts

States Become More Aggressive with PBM Reform

State efforts are aiming to bring more disclosure and transparency to PBM practices, mandating certain pharmacy reimbursement levels,...

4 min read

NC PBM reform update

NC PBM reform update

NC Senate passes bill to reform prescription drug market, enhance transparency

News & Observer Reporter: Luciana Perez Uribe Guinassi The North Carolina Senate passed Wednesday, with unanimous support, a bill...

2 min read

DOGE must investigate PBMs

DOGE must investigate PBMs

Pharmacist group tells Elon Musk's team to probe pharmacy benefit managers

A trade group hopes to aim the Department of Government Efficiency at its members' adversaries to "eliminate waste." ALM Benefits Pro...

1 min read

Educate Patients About How PBMs’ Vertical Integration Impacts Their Health Care

Educate Patients About How PBMs’ Vertical Integration Impacts Their Health Care

Educate Patients About How PBMs’ Vertical Integration Impacts Their Health Care

Pharmacy Times Author: Muhammad Cheema, PharmD Imagine walking into your pharmacy only to find that your medication is no longer...

2 min read

Commentary: Why your pharmacy may be disappearing

Commentary: Why your pharmacy may be disappearing

Commentary: Why your pharmacy may be disappearing

While multiple factors can contribute to a business closing, the additional costs Pharmacy Benefit Managers impose on pharmacies...

Independent Pharmacy

2 min read

Save Local Pharmacies Act passes in both chambers in the Virginia general assembly

Save Local Pharmacies Act passes in both chambers in the Virginia general assembly

Save Local Pharmacies Act passes in both chambers in the Virginia general assembly

The bill aims to protect Virginians' access to healthcare and lower costs by creating a single benefit manager for the state's Medicaid...

2 min read

Medicare Drug Price Negotiations Expose Community Pharmacies to Financial Risk

Medicare Drug Price Negotiations Expose Community Pharmacies to Financial Risk

Medicare Drug Price Negotiations Expose Community Pharmacies to Financial Risk

A survey conducted by 3 Axis Advisors revealed potential impacts of the Inflation Reduction Act’s Medicare Drug Price Negotiation...

Medicare/Medicaid

2 min read

As cuts loom, state Medicaid programs leave millions in drug rebates on the table

As cuts loom, state Medicaid programs leave millions in drug rebates on the table

As cuts loom, state Medicaid programs leave millions in drug rebates on the table

Yahoo News Reporter: Shalina Chatlani Chemotherapy drugs used in cancer treatments can be administered in a health provider’s office or...

Medicare/Medicaid

3 min read

Diagnosing the Problem With PBMs' Incentives

Diagnosing the Problem With PBMs' Incentives

Diagnosing the Problem With PBMs' Incentives

Real Clear Markets Reporter: Justin Leventhal Pharmacy Benefit Managers (PBM) sit in the center of our prescription drug system,...

2 min read

FTC finds middlemen inflate specialty generic drug prices by billions of dollars

FTC finds middlemen inflate specialty generic drug prices by billions of dollars

FTC finds middlemen inflate specialty generic drug prices by billions of dollars

CNN Reporter: Tami Luhby Pharmacy benefit managers, which serve as the middlemen between drug makers, insurers and pharmacies, reaped...

1 min read

Pharmacy Benefit Managers Drive Up Costs

Pharmacy Benefit Managers Drive Up Costs

Pharmacy Benefit Managers Drive Up Costs

Newsmax Reporter: Mark Swanson Rep. Jake Auchincloss, D-Mass., is taking aim at three pharmacy benefit managers (PBMs) that operate...

2 min read

How Pharmacy Benefit Managers Are Harming Patients—and What Policymakers Can Do About It

How Pharmacy Benefit Managers Are Harming Patients—and What Policymakers Can Do About It

How Pharmacy Benefit Managers Are Harming Patients—and What Policymakers Can Do About It

The Century Foundation Author: Thomas Waldrop , Fellow Earlier this year, the Federal Trade Commission (FTC) announced that it had begun...

5 min read

The Costly Failures Of Medicine’s Middlemen

The Costly Failures Of Medicine’s Middlemen

The Costly Failures Of Medicine’s Middlemen

Forbes Robert Pearl, M.D. Forbes Contributor The American medical system has become undeniably complex, a far cry from the days when...

3 min read

PBM Math: Big Chains Are Paid $23.55 To Fill a Blood Pressure Rx. Small Drugstores? $1.51

PBM Math: Big Chains Are Paid $23.55 To Fill a Blood Pressure Rx. Small Drugstores? $1.51

PBM Math: Big Chains Are Paid $23.55 To Fill a Blood Pressure Rx. Small Drugstores? $1.51

KFF Health News Reporter: Andy Miller While customers at Adams Family Pharmacy picked up their prescriptions on a hot summer day, some...

Independent Pharmacy

3 min read

Employers Haven’t a Clue How Their Drug Benefits Are Managed

Employers Haven’t a Clue How Their Drug Benefits Are Managed

Employers Haven’t a Clue How Their Drug Benefits Are Managed

KFF Health News Reporter: Arthur Allen Most employers have little idea what the pharmacy benefit managers they hire do with the money...

2 min read

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