Pres. Biden's administration on Thursday unveiled a new framework allowing authorities the right to seize certain drug patents and license them to other manufacturers in order to lower drug prices.
As lawmakers scrutinize the nation's pharmacy benefit managers, the California insurer expects to save $500 million in annual drug costs by replacing most of CVS Health's PBM services by January 2025.
The Federal Trade Commission launched its inquiry of the 6 largest PBMs in June 2022, after Sen. Chuck Grassley (R-Iowa) had pressed the commission for years to review their role in determining prices for prescriptions like insulin.
The state AGs sent a letter to Senate and House leaders, highlighting the urgent need for federal action to mandate that pharmacy benefit managers increase transparency into their practices by sharing pricing with health plans.
Cost Plus Drugs CEO Mark Cuban was invited to the White House, along with other business and government leaders, to discuss PBM reform, while a trade group for pharmacy benefit managers said they were not invited.
Cost Plus Drug Co., which sells drugs at a discounted rate, has reached an agreement with Community Health Systems, based in Franklin, Tenn., to purchase certain hard-to-source pharmaceuticals, such as epinephrine.
Sen. Bernie Sanders, chair of the Senate Health, Education, Labor and Pensions Committee, has demanded to know why Americans pay "$1,349 a month for [weight loss] prescription drugs that cost less than $5 to manufacture."
The Pfizer settlements come as GSK, a previous Zantac manufacturer, defends itself in an ongoing trial, while Sanofi, which recalled the drug in 2019 over cancer claims, agreed to pay more than $100 million to resolve its Zantac cases.
Providers, insurers and regulators need to come together to ensure the safe use of these drugs, mitigate failed treatment attempts, reduce side effects and provide better insurance plans to support patients in need.
The agency has stepped up its campaign against drugmakers' improper listing of patents in the FDA's Orange Book, which it contends are ploys intended to delay generic competition, by disputing junk patent listings for 300 drugs.
Discussed below are some of the most common contractual provisions that plan fiduciaries and benefits advisors must know to avoid and/or expose a self-serving PBM.
Pharmacy benefit manager Optum Rx plans to launch Clear Trend Guarantee in 2025 to allow employers and health insurers to more easily manage their drug spending, while creating more predictability for patients around costs.
An Illinois jury sided with drugmakers GlaxoSmithKline and Boehringer Ingelheim in the first trial over Zantac, which the FDA recalled in 2020 over claims the over-the-counter heartburn medication caused cancer.
Patients are being harmed by Express Scripts and other pharmacy benefit managers that prevent them from using their preferred pharmacies, resulting in decreased availability of medications and higher drug prices, say protestors.
"Teva stifled would-be generic competitors to QVAR because the drug laws do not allow for generic substitution of a given drug-device combination unless the generic is approved for that specific drug-device combination," the complaint alleged.
At a Senate Judiciary Committee hearing, Senators accused drugmakers of gaming the system by filing 100+ patents for any given drug, while trade group PhRMA said the system advances "the development of new medicines."
Ozempic, Trulicity and Mounjaro were first approved to treat diabetes, however, in the last three years, the FDA has approved rebranded versions of Mounjaro and Ozempic for weight loss, leading demand – and prices – to skyrocket.
As the drugmaker moves into Phase III studies for survodutide, its new GLP-1 obesity drug, Walgreens will use its community pharmacies as clinical trial sites, aiming to improve access and address equitable health representation.
Five of the suits were filed by Esperion Therapeutics, which seeks to stop competitors from selling generic versions of the company's cholesterol drug Nexletol.
While the public may view these drugs as a silver bullet solution, there is also a cloud of potential misinformation regarding who should use them, possible side effects, and other long-term risks and successes.
Twenty-six of the 28 physicians included in the study received payments from pharmaceutical companies for a variety of reasons, most often noted as food and beverages, speaking or consulting fees.
In a major victory today for the Biden administration, the high court has upheld broad access to mifepristone, the widely used abortion pill, overturning an appeals court ruling that barred mail-order prescriptions.
While shortages of the popular weight loss drugs persist, Hims & Hers, a San Francisco-based telehealth company, will offer access to a compounded form of the GLP-1 weight-loss drugs, starting at $199 a month.
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.
"We believed in our case, and that is why we committed so many resources to litigating it. And in the end, you know, I believe that we got a very excellent result," said Sherrie R. Savett of Berger Montague, who represented the plaintiff.
Democratic Attorney General Charity Clark said CVS Health's Caremark, Cigna Group's Express Scripts and several of their affiliates pushed patients toward more-expensive drugs even when less-expensive alternatives were available.
The PBM industry is currently experiencing a confluence of technological, regulatory, and marketplace changes that will impact PBMs that operate with opaque business practices and antiquated technology.
The Wells Fargo plan paid almost $10,000 for a generic pill for multiple sclerosis that Wegmans pharmacies sold for $648, according to the complaint, driving up premiums and out-of-pocket costs.
