Many states have enacted legislation to reform the business practices of the Pharmacy Benefit Manager (PBM) industry. For example, a number of states have enacted such laws as the Fair & Uniform Pharmacy Audits, PBM Regulation/Transparency, and... Read More
This past week, the much touted Walgreens-Prime Therapeutics Strategic Partnership went into effect. Both companies have heralded the partnership as a new way to leverage pharmacy benefits management with a large retail pharmacy chain, with the goal... Read More
We are receiving information about a disturbing new trend involving potential price gouging by PBMs. PBMs may have been charging patients copayments for prescription drugs that exceed the actual cash price of the drug. PBMs later recoup from the... Read More
Plan sponsors and their administrators, such as Pharmacy Benefit Managers (PBMs), are increasingly imposing Direct and Indirect Remuneration ("DIR") fees on independent pharmacies nationwide, with a focus on pharmacies in a... Read More
Pharmacy Benefit Managers (PBMs) own their own Specialty Pharmacies (SPs) and convince Plan Sponsors to allow the PBMs to become the exclusive provider of expensive specialty drugs. PBMs have recently enjoyed significant revenue expansion and... Read More
This past week, Humana announced a 46% decrease in profits stemming largely from the costs associated with the ongoing Aetna merger, which is anticipated to close in the second half of 2016. As part of the transaction, Aetna is set to acquire... Read More
