The U.S. Supreme Court this month heard oral arguments in the case of Rutledge v. Pharmaceutical Care Management Association. At issue is the right of states to regulate pharmacy benefit management (PBMs) companies, which employers and health plans hire as middlemen to manage their prescription benefit programs for workers and other plan members.
During oral arguments on Oct. 6, several justices asked about the burden that health plans encounter when PBM regulations differ from one state to another, as Rachel Cohrs reported for Modern Healthcare. Continue reading
The Federal Trade Commission and State of New York late last month filed a lawsuit against Martin Shkreli, charging that Shkreli and Vyera Pharmaceuticals raised the price of the life-saving drug Daraprim by more than 4,000% and worked to corner the market for such drugs.
“The joint action accused Shkreli and Vyera Pharmaceuticals, formerly known as Turing Pharmaceuticals, of scheming to ‘illegally’ prevent would-be generic competitors from selling a version of Daraprim,” as Stat’s Ed Silverman reported on Jan. 27. After acquiring the drug in 2015, Shkreli, dubbed the “Pharma Bro,” and Turing raised the list price of the medication from $17.50 per tablet to $750, he added. Continue reading
Source: 2018 Janssen U.S. Transparency Report. Reprinted with permission.This illustration from a Janssen Pharmaceutical Companies report shows how drug makers pay rebates across the pharmacy supply chain.
One of the big health care stories of the past few years has been how much money pharmaceutical manufacturers spend on rebates to promote prescription drugs. Pharmaceutical companies pay out rebates to just about every participant in the supply chain.
A report issued last year from the Janssen Pharmaceutical Companies (a division of Johnson & Johnson) showed that pharma companies give rebates to those companies that pay for health care (including health insurers, the government, and employers) and to PBMs, hospitals, physician groups, specialty pharmacies, wholesalers, government distributors, and to patients themselves.
Paying rebates to pharmacy benefit managers (PBMs) helps pharmaceutical companies keep medications on formularies, enticing health care purchasers to buy more drugs. Continue reading
A recent study from the Commonwealth Fund and the Pacific Business Group on Health (PBGH) shows that developing a waste-free formulary by cutting the number of high-cost, low-value drugs in employers’ health benefit plans could save employers as much as 24% in pharmacy spending.
Concern about rising prescription drug costs has caused large self-insured employers to develop innovative formularies for the pharmacy benefit plans they provide to employees, their family members and retirees. A formulary is a list of drugs that employers and health plans include in their benefit plans for employees and members. Continue reading
With the news out of Washington coming at us fast and furiously, it may have been easy to miss the introduction of House Speaker Nancy Pelosi’s new proposal to curb the cost of prescription drugs.
Drug pricing is an especially important issue for older adults, many of whom are on multiple medications and take more prescription drugs on average than any other age group in the United States, according to the American Geriatrics Society.