Instant Insights The Prescription Drug Problem & PBM Reform

According to a new study, from January 2022 to January 2023, an average price increase of $590 occurred for more than 4,200 drugs.

The government plans to bill the drugmakers for the rebates by late 2025, as part of the new Inflation Reduction Act requirement.

The Treat and Reduce Obesity Act provides coverage for patients who had an insurance plan that covered the new weight loss drugs, like Wegovy and Ozempic, before they entered Medicare.

Lisa Gomez, EBSA's chief, testified at a House hearing that the Labor Department has the statutory authority to stop that.

A state board picked those products and two others for reviews that could lead to "upper payment limits."

For brand-name drugs, the average margin gap may be more than $65 per 30-day prescription.

One commissioner voted against release, saying the report lacks "economic rigor expected of Commission reports."

According to the report, new clients realized an average of 11% reduction in costs compared to the previous year, with a different PBM.