Category: PBMs
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New PBM law could open door to direct sales between employers, drugmakers
New PBM law could open door to direct sales between employers, drugmakers WASHINGTON — The pharmacy benefit manager reforms that President Trump signed into law on Tuesday could lead to employers buying drugs directly from drugmakers, just like the administration is encouraging individual consumers to do through its pending website TrumpRx. The PBM reforms are…
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STAT+: FTC settles lawsuit with Express Scripts over charges it manipulated insulin prices, impeded access
STAT+: FTC settles lawsuit with Express Scripts over charges it manipulated insulin prices, impeded access The Federal Trade Commission said Wednesday that it had settled a lawsuit against Express Scripts, one of the largest pharmacy benefit managers in the U.S., over allegations that the company artificially inflated the price of insulin and impeded access to…
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STAT+: New rule would force PBMs to disclose drug rebates and other fees
STAT+: New rule would force PBMs to disclose drug rebates and other fees Pharmacy benefit managers face new, sweeping requirements to disclose all the different ways they get money from providing drug coverage. The proposed rule from the Department of Labor published on Thursday would be a significant change for an industry that shields prescription…
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STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding
STAT+: What’s in Congress’ sweeping health care deal: PBM reform, telehealth, science funding WASHINGTON — Congress has reached a deal on several health care policies, including a crackdown on drug-industry middlemen, transparency measures for hospital billing, pediatric cancer research measures, and Medicare coverage of multi-cancer screening tests. Those measures are part of a bill to…
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STAT+: Three major health care policy issues to watch in 2026
STAT+: Three major health care policy issues to watch in 2026 WASHINGTON — Health care figured prominently in the first year of President Trump’s second term, and it’ll likely play an even bigger role leading up to the 2026 midterm elections. The shift back to health care politics has been somewhat surprising. Although Republicans were…
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STAT+: Pharmaceutical industry evades drug price transparency, again
STAT+: Pharmaceutical industry evades drug price transparency, again Drug manufacturers and pharmacy benefit managers received a holiday gift from President Trump on Friday: They still will not have to publicly post the actual prices of prescription drugs, more than five years after federal law required them to do so. Net drug prices — the amounts…
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STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews
STAT+: UnitedHealth proclaims audits show it has ‘robust’ procedures, in contrast to findings of independent reviews UnitedHealth Group said Friday that the consultants it hired to audit its operations, including its practice of applying lucrative diagnosis codes to older adults’ records, found they’re not only “robust,” but “industry leading.” While the reports give a veneer…
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STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit
STAT+: Cigna stock nosedives on news that ending PBM rebates will lower that segment’s profit The stock market pummeled Cigna on Thursday after the company’s leaders revealed that their new plan to ditch pharmacy benefit rebates will lower that segment’s profit in the coming years. By midmorning, the company’s stock had plunged more than 15%. …
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STAT+: DeSantis downplays importance of health insurance as the government shutdown drags on
STAT+: DeSantis downplays importance of health insurance as the government shutdown drags on You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays. You might have noticed that the subject line of Tuesday’s newsletter…
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STAT+: U.S. judge blocks first-in-the-nation law barring companies from owning PBMs and pharmacies in Arkansas
STAT+: U.S. judge blocks first-in-the-nation law barring companies from owning PBMs and pharmacies in Arkansas In a closely watched case, a U.S. federal court judge has temporarily blocked a first-in-the-nation law that would prohibit companies that own pharmacy benefit managers from also operating both retail and mail-order pharmacies in Arkansas. The state law is designed…
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STAT+: Supreme Court declines to review Oklahoma law regulating PBMs
STAT+: Supreme Court declines to review Oklahoma law regulating PBMs The U.S. Supreme Court has declined to review an appeals court ruling that struck down key parts of an Oklahoma law regulating the retail networks created by pharmacy benefit managers, a victory for the controversial middlemen in the pharmaceutical supply chain that may create uncertainty…
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STAT+: Arkansas adopts first-in-the-nation law forcing companies to choose between running a PBM or pharmacies
STAT+: Arkansas adopts first-in-the-nation law forcing companies to choose between running a PBM or pharmacies Arkansas Gov. Sarah Sanders has signed a first-in-the-nation law that prohibits pharmacy benefit managers from operating both retail and mail-order pharmacies, a move designed to eliminate a conflict of interest that has been blamed for boosting the price of medicines…
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STAT+: Canada advances an antitrust probe into Express Scripts over ‘patient steering’ and pharmacy fees
STAT+: Canada advances an antitrust probe into Express Scripts over ‘patient steering’ and pharmacy fees Canadian officials have obtained a court order that requires Express Scripts to produce documents in connection with an investigation into whether the pharmacy benefits manager violated antitrust laws. The Competition Bureau is examining whether the company forced or induced Canadians…
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STAT+: Tennessee officials find Express Scripts violated law governing commercial pharmacy claims
STAT+: Tennessee officials find Express Scripts violated law governing commercial pharmacy claims In an unusual move, an audit of commercial health plans by Tennessee officials found that Express Scripts, one of the largest pharmacy benefit managers in the United States, violated state laws in its dealings with pharmacies, according to newly released documents. Specifically, the…
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STAT+: Arkansas may force companies to choose between running a PBM or pharmacies
STAT+: Arkansas may force companies to choose between running a PBM or pharmacies File this under “You can’t have it both ways.” An Arkansas bill that would prohibit pharmacy benefit managers from operating retail and mail-order pharmacies was passed by the state senate and is now headed to Gov. Sarah Sanders, the first time such…