The same three #PBM companies as last year still control 80% of the market. #MarketConsolidation #RxCosts
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Lawmakers decided to put off their vote to take more time to consider their findings. It’s now on the committee’s March 24 calendar. #Tennessee #FairRX #Legislation #PBM #RxCosts
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The manufacturers of all 15 drugs selected for this round have agreed to participate in the #Medicare negotiation program, along with the manufacturer of one drug selected for renegotiation. #RxCosts #CMS
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The program, #GoodRx Employer Direct, launched earlier this year with an initial focus on GLP-1s. The program also includes an employer-branded version of GoodRx’s #telehealth services. #RxCosts #EmployeeBenefits
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PerformRx will wrap operations “in their current form” Dec. 31. The switch to Optum Rx will go into effect at the start of 2027. #PBM #Consolidation #Monopolization #RxCosts
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PBMs accept the need for more #PriceTransparency. And "it should be applied across the supply chain." #MyOpinion: sounds good to me. #PBM #RxCosts
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Employers and #PBM that violate the #ReportingRules in the new federal pharmacy benefit manager laws could end up owing $10,000-$100,000 in fines per violation per day. #ouch #ButNeeded #RxCosts
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Although #TrumpRx may offer savings for some cash-paying patients, pricing comparisons suggest most insured Americans are still likely to find lower costs elsewhere. #RxCosts
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#ExpressScripts' settlement contains provisions requiring it to work with local pharmacies and disclose #RxCosts to employers annually.
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Going into 2026, #PBM reforms have been picking up steam. The House passed elements of a reform under the Consolidated Appropriations Act (#CAA). Several #pharmacy groups have backed the efforts. #RxCosts #Legislation
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All five CEOs cited #HospitalConsolidation, #RxCosts, lack of #PriceTransparency, and the cost of specialty services and diagnostic testing as the reason for rising premiums. “The cost of #HealthInsurance is driven by the cost of #healthcare. It is a symptom, not a cause."
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#California, pharmacy groups, and some employer groups have argued that the state needs to act to protect them from #PBM actions. PBMs have argued that other players in the prescription drug #SupplyChain are attacking them mainly because of their success. #RxCosts #ERISA #Litigation
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The complaint alleges that manufacturers required PBMs to inflate drug prices to gain formulary access and then paid an undisclosed amount of the cost back to the #PBM. #RxCosts #Insulin #Drugmakers #Litigation #Virginia
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The bill, the #PBM Fiduciary, Accountability, Integrity and Reform Act, or PBM FAIR Act, would add a PBM #fiduciary section to #ERISA. In addition to bipartisan support, the ERISA Industry Committee is supporting it. #legislation #RxCosts
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#OptumRx says its response from participating pharmacies to date has been positive. #PBM #Reimbursement #RxCosts
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Compared to independent physician practices, drug price #markups were 6.59 times and 4.34 times as high at 340B-eligible hospitals and noneligible hospitals, respectively. #RxCosts
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The caps apply to the individual and small employer markets, and insurers must provide the medications without a deductible. The regulations also require coverage of hearing aids and cochlear implants under a separate law. #NewJersey #Insulin #RxCosts #EpiPen #Inhalers
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33% of U.S. adults told eHealth that they wanted to try drugs like Wegovy once the price comes down. #GLP1 #RxCosts
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Direct-to-employer programs could save members "billions and billions of dollars," #MarkCuban asserted. #Humana #RxCosts #PBM
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The bill, a follow-up to the #InflationReductionAct, also expands this ability to the commercial market, which would reach more than 188 million additional Americans. #Legislation #RxCosts
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The #rulemaking process began May 23 and concluded Oct. 3, setting a $600 cap on a 50-milligram dose of #Enbrel. #Colorado #RxCosts #DrugCosts #prescriptions
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The report marks 60 days since President Trump sent letters to #drugmakers requesting price reductions. In that time [alone], 87 drugs have gone up in price, with a median increase of 8%. Companies raised prices after receiving the administration’s request. #RxCosts
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The #Pfizer agreement is a part of the White House agenda to secure "most favored nation" pricing with #pharmaceutical manufacturers. Neither Pfizer nor the White House have released specific #drug prices yet. #RxCosts #StoppedClocks
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The survey identified the top five #strategies that respondents (including #employers) are using to mitigate #pharmaceutical expenses without compromising the quality of care. #RxCosts #EmployeeBenefits #PharmacyBenefits
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This report comes at a time of heightened scrutiny of low competition and high vertical integration in the #PBM industry. #RxCosts #RxBenefits
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The letters represent an escalation of the administration’s push to tie the prices of #prescriptions in the U.S. to the lowest found among comparably wealthy nations. #RxCosts #StoppedClocks #TrumpAdministration buff.ly/g7aMQiw
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#Pediatric #drugs are expected to have the highest inflation rate, at 3.93%. #ImmuneGlobulin products have become the top drugs by spend. Pharmaceutical #tariffs were not factored into the 2026 projection. #RxCosts #Prescriptions
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Medical cost trend will reach 8.5% in 2026 for #healthplans via @PwC Behind the Numbers
What's #healthcare cost-increasing? #Hospitals costs, #GLP1s & meds, #RCM & #behavioralhealth
tinyurl.com/yymbsaa6
#HealthInsurance #HealthCosts #HealthEconomics #Mentalhealth #Rxcosts
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More details will likely be announced at the end of the month, once a probe into the issue is completed. #Tariffs #Rx #RxCosts #TrumpAdministration #pharmaceuticals buff.ly/WlqIrQY
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