News
from the fight to #SaveIndiePharmacy
New York Times’ The Middlemen series
FTC case against Caremark, Express Scripts, Optum Rx can move forward, judge rules
A Missouri district court judge on Tuesday said stopping the FTC’s suit against the Big Three PBMs would be “against the public’s interest.”
How PBMs limit access to MS therapies
Pharmacy benefit managers inflate specialty generic prices, restrict pharmacy choice and increase patient costs, leaving many life-saving multiple sclerosis therapies inaccessible.
Mark Cuban shakes up pharmacy pricing
Mark Cuban is best known for business and basketball, but lately, his passion has been shaking up the pharmaceutical world by showing the wholesale costs of many generic drugs and an independent pharmacist from Minnesota was among those he consulted with for wholesale pricing.
How changes to a CDC vaccine panel under Kennedy could reshape policy
As Secretary of Health and Human Services, Robert F. Kennedy Jr. has sweeping authority over the country's immunization policies. During confirmation hearings, he clashed with Senate Democrats over his stance on vaccines.
Medicare Drug Coverage Is Often Inadequate—Here’s Why
American healthcare spending dwarfs that of every other wealthy country, and the cost of Medicare, alone, threatens the fiscal viability of the federal government. If insurers do not try to hold down the cost of American medical care, who will?
‘Terrifying’: Public Health Experts React to Senate’s Confirmation of RFK Jr. to Lead HHS
The Senate confirmed Robert F. Kennedy Jr., one of America’s most notorious vaccine skeptics, to run the country’s leading health agency, the U.S. Department of Health and Human Services (HHS), on Thursday, sparking outrage among public health experts who worry that Kennedy will harm public health and further erode trust in science and medicine.
Congress must take on Pharmacy Benefit Manager Reform. It's a bipartisan win | Opinion
The U.S. is increasingly politically polarized, with few issues where voters and elected officials on both sides of the aisle find common ground. But over the past year, one issue has brought everyone together: a distrust of pharmacy benefit managers (PBMs).
Mobile pharmacy brings meds to Winthrop customers after losing brick and mortar store
Lotus Pharmacy is a woman-owned company that began working in Winthrop delivering meds to assisted living and independent living residents after the town’s pharmacy closed.
‘It’s a money game to them’: a son takes on UnitedHealth over his elderly father’s care
Robby Martin has joined a lawsuit against UnitedHealth after the insurance giant cut off his father’s nursing home coverage – five days later his father died at home
Adult Swim’s Common Side Effects Show Pitfalls of Medicare Advantage
The show follows once-separated high school friends Marshall, a mycologist, and Frances, the executive assistant to a pharmaceutical executive, who reconnect after Marshall begins peppering Frances’ boss with questions during a public event announcing a new drug the pharmaceutical company is launching.
22 states sue to block Trump administration cuts to NIH research payments
Attorneys general seek court order to halt 15% cap on research overhead costs
Pharmacies are fed up with PBMs. Here’s what reforms might be coming
Pharmacy benefit managers are under increasing scrutiny due to accusations that they are driving their smaller and more vulnerable independent counterparts out of business.
Drug Costs and Their Impact on Care: Insights from Medicare Patients and Providers
Prescription drug costs are a barrier to care for many patients, but especially so for the nine of 10 Medicare beneficiaries who report taking prescription drugs regularly. In fact, 14 percent of beneficiaries age 65 or older say they skip taking or sometimes do not even fill their prescriptions because of the expense.
UnitedHealth Is Sick of Everyone Complaining About Its Claim Denials
Two months after UnitedHealthcare’s CEO was murdered, the insurer is moving to protect its image
How Medicare Says It Arrives At ‘Fair’ Prescription Drug Prices
When former President Biden signed the Inflation Reduction Act into law in 2022, he said that drug price negotiations and other provisions in the legislation would help lower costs for Medicare beneficiaries by bringing down the prices of certain medicines and capping out-of-pocket costs for many others. What remained hidden from view, however, is how the so-called maximum fair prices of the drugs selected for negotiation are determined. Now we have a glimpse behind the curtain. But it is only a peek.
Cigna sues, wants leeway to tell customers which pharmacies to use
In 2019, Minnesota passed the Minnesota Pharmacy Benefit Manager Licensure and Regulation Act. It prevents Pharmacy Benefit Managers or PBMs from requiring customers on an insurance plan to go to a pharmacy that the PBM owns, often by mail order.
Lawmakers want Indiana to own its own pharmacy benefit manager for state plans like Medicaid
The goal of the bill is to give Indiana a “seat at the table” to play a role in negotiating rebates, pricing, distribution and dispensing fees
Op-Ed: FTC Adds Fuel to the Fire for PBMs. Will Congress Deliver Real Reform?
The FTC's reports and legal actions target PBMs for inflating drug costs and restricting access, focusing on insulin and specialty generics.
Kansas pharmacists are closing their doors as they seek a way to save their businesses struggling from PBM practices
92 independent, mom-pop pharmacies across the state will close their doors for a day of advocacy in Topeka. It’s a situation pharmacists said, without action, will see more pharmacies close. That will make it hard for patients who need them.
Independent pharmacies fight back as PBM reform gains steam
Independent pharmacists across Virginia are rallying behind legislation to reform PBMs, arguing the change is critical for rural healthcare access.
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.