News Wire

Despite Lawsuits Over Drug Prices, Insurance Giant Touts Revenue Growth, Claims To Have Lowered Drug Costs

As congressional lawmakers feuded over the fate of the nation’s health care system, insurance giant UnitedHealth Group reported stellar second-quarter earnings, which included more than $15.8 billion in revenue for a business segment at the roots of multiple class-action lawsuits against the company — and one that many blame for skyrocketing drug prices in the U.S.

The company faces three class-action lawsuits, one of which is a combination of two earlier class-actions, alleging that it violated the Employee Retirement Income Security Act, or ERISA, which mandates that the insurer and its pharmacy benefit managers act as fiduciaries — that is, act in the interests of their customers. The accusations outline a system of drug price-gouging, in which the pharmacy benefit manager — in UnitedHealth’s cases, OptumRx — allegedly forced pharmacies to charge fraudulent premiums for prescription medications and pocketed the difference.

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International Business Times

By @LydsONeal On

Pharmacy benefits manager Appro-Rx on bringing clarity to drug…

Kyle Fields, Appro-Rx CEO, discusses how his company is working on transparency in drug pricing as a pharmacy benefits manager.

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CNBC

Kyle has been the owner of Appro-Rx since 2008 and has served as President and COO since 2010 and Co-CEO since 2016. Kyle oversees all aspects of the daily operations at Appro-Rx including sales, plan implementation, call-center operations, member and pharmacy help desk, contract negotiations, client retention and acquisition, government relations, and quality control. Kyle has an extensive background in Insurance and Insurance management, government relations, government finance, and extensive business and contract negotiations. Kyle is a former city councilman, was named to the 2014 40 Under 40 of Dayton, Ohio.

EpiPen lawsuit targets drug price middlemen

A new class action lawsuit challenging the price of EpiPens is targeting not the drug’s manufacturer, but three pharmacy benefit managers and the industry’s rebate practices.

The lawsuit alleges CVS Health, Express Scripts and Prime Therapeutics, cause price gouging — including the more than 500 percent increase in EpiPen’s price from 2007 to 2016 — by demanding increased rebates from manufacturers in exchange for favorable placement on their formularies

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Dayton Daily News

Katie Wedell

Feeling the pain of rising drug prices? Blame the middle man

While Washington wrangles with a replacement for Obamacare, patients across the country continue to battle one of the biggest everyday obstacles to good health care: Rising drug prices.

Prescription drugs account for 10 percent of the $3.2 trillion in overall health care spending, outpacing all other health care services, according to government statistics. Consumers with diabetes, cancer and leukemia are some of the most likely to feel pain at the pharmacy due to recent drug price hikes. The cost of two common types of insulin, for instance, increased 300 percent in the past decade.

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New Paper Observes That PBMs Are Middlemen That Obtain Huge Profits But Don’t Actually Make Anything

The evidence against pharmacy benefit managers (PBMs) just keeps piling up. A new report by Merrill Matthews and Peter Pitts of the Institute for Policy Innovation examines price transparency in the health care market, and concludes that PBMs reap gigantic profits and are a major contributor to higher drug costs. The authors point out that “a lot of money is made in the health care system by middlemen who don’t actually treat patients” and that PBMs “don’t actually make anything.”

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