News
from the fight to #SaveIndiePharmacy
New York Times’ The Middlemen series
Eagan’s Prime Therapeutics hit with $10.3M judgment in price-fixing case
Safety net provider alleged pharmacy benefit manager collaborated with a rival to set low payment rates to pharmacies.
'Knock out the middlemen' is a campaign promise Donald Trump should keep
Congressional leaders in December struck a deal to rein in PBM practices, but the bill fell apart. President Trump has pledged to “knock out the middlemen ” in health care, so the time is ripe for Congress to reconsider the issue.
PBM Prime Therapeutics to Pay $10 Million Antitrust Case Over Price-Fixing Scheme with Express Scripts, Inc.
In a recent antitrust arbitration ruling, Prime Therapeutics, a pharmacy benefit manager (PBM) owned by 19 Blue Cross and Blue Shield Plans, was found guilty of engaging in horizontal price-fixing in collaboration with Express Scripts, Inc. (ESI), a competitor owned by Cigna.
Congress Can't Wait—Reform Pharmacy Benefit Managers and Deliver Lower-Cost Drugs for Patients | Opinion
As the 119th Congress convenes, policymakers have a historic opportunity to lower prescription drug prices for Americans. As members of Congress begin negotiating the continuing resolution set for March, they can make prescriptions more affordable for Americans and eliminate government waste in the American health care system by prioritizing pharmacy benefit manager (PBM) reform.
Pharma is hopeful about Trump’s second term — here’s what to expect for drugmakers
Pharmaceutical companies appear to be hopeful about their growth under a Trump administration, after former President Joe Biden took a hardline stance on the industry for the last four years.
New AI tool counters health insurance denials decided by automated algorithms
Insurance coverage denials have risen in recent years in the US, driven in part by automated algorithms powered by AI – and some recently launched artificial intelligence tools may fight back by generating automatic appeals.
1 in 2 Americans affected by UnitedHealth cyberattack, new disclosure shows
Updated tally at Change Healthcare, owned by the Eden Prairie-based health care giant, nearly doubles the number of people affected by the massive data breach.
NCPA Joins Class Action Suit Against GoodRx; CVS Caremark Corp.; Express Scripts, Inc.; MedImpact Healthcare Systems, Inc.; and Navitus Health Solutions, LLC
Says the discount card company is colluding with the named PBMs to fix reimbursements
‘Rationing by inconvenience’: Health insurers count on customers not appealing denials
For many patients, the appeal process is just too much
Oklahoma takes CVS Caremark to new PBM court over alleged underpayments
Oklahoma's attorney general has accused CVS's Caremark pharmacy benefit manager unit of under-reimbursing pharmacies for prescription drugs
Pharmacy Comes Full Circle as Site of Care
Historically, pharmacists were community-based healthcare providers who made and prescribed medicines. With rapid shifts in healthcare occurring in the 20th and 21st centuries, pharmacies once again should be considered as low-cost medical homes for patients.
NEWS RELEASE: OptumRx and Walgreens Sued Over the Death of Twenty-Two-Year-Old Who Couldn’t Afford His Asthma Medication
The lawsuit alleges that on January 10, 2024, Cole tried to fill his prescription for Advair Diskus, an asthma inhaler he had taken for many years, but was told that it would cost him $539 out-of-pocket because it was no longer covered by his insurance.
DOJ sues Walgreens, alleging it ‘knowingly’ filled millions of prescriptions that lacked legitimate medical purposes
“This lawsuit seeks to hold Walgreens accountable for the many years that it failed to meet its obligations when dispensing dangerous opioids and other drugs,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the DOJ’s Civil Division.
WATCH: Arkansas Pharmacists Association, AG Tim Griffin talk pharmacy benefit manager reform
The Arkansas Pharmacists Association and Attorney General Tim Griffin held a press conference at 10:30 a.m. Thursday regarding statewide pharmacy benefit manager reform legislation.
Key Facts on Health Coverage of Immigrants
As of 2023, half (50%) of likely undocumented immigrant adults and one in five (18%) lawfully present immigrant adults reported being uninsured compared to less than one in ten naturalized citizen (6%) and U.S.-born citizen (8%) adults.
FTC Releases Second Interim Staff Report on Prescription Drug Middlemen
Report finds PBMs charge significant markups for cancer, HIV, and other critical specialty generic drugs
UnitedHealth Group ordered to pay $165 million over deceptive sales practices
UnitedHealth Group will appeal an order to pay $165 million in penalties and restitution after a judge found a business acquired by the Eden Prairie-based insurer more than five years ago used deceptive practices to sell benefits that supplement traditional health insurance in Massachusetts.
Healthcare insurance companies blamed for 'pharmacy deserts' in Minnesota
Pharmacy benefit managers are being blamed for "pharmacy deserts" being left across Minnesota as inflating drug costs squeeze out small-town pharmacies. This local news story features our friend and fellow pharmacy advocate, Deborah Keaveny, RPh of Keaveny Drug (Winsted, MN)!
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.