Employer Issues

Excessive prescription refilling by mail-order pharmacies leaves piles of unneeded pills; 'Every time, there are 15 extra' The Wall Street Journal Reporters: Christopher Weaver , Tom McGinty , and Anna Wilde Mathews U nitedHealth Group’s pharmacy mailed Medicare recipient Bill Zielinski so many refills of the cholesterol drug atorvastatin that his unused stash could last a year on the pill-a-day regimen his doctor ordered. Excessive refilling is common practice at U.S. mail-

You’ve probably heard of ghost kitchens, those restaurants that exist only on delivery apps with no physical storefront for customers to visit. But have you ever heard of ghost networks? They’re not spooky Halloween décor or the latest streaming conspiracy. Ghost networks are the phantom pharmacy networks that pharmacy benefit managers and insurance companies claim to exist on paper, but have little basis in reality. If you’ve ever tried to help a patient find an in-network p

How the CBO Became PBMs’ Sidekick If you think the biggest obstacle to fixing PBMs is their billion-dollar lobby, bless your heart, because you’re only half right. The other half? A government spreadsheet in D.C. quietly strangling real reform before it ever has a chance. Meet the Congressional Budget Office (CBO). The unelected, unaccountable scorekeeper that can take a bipartisan, common-sense bill and file it under “too expensive” with the click of a keystroke. Officially,

Oklahoma decision viewed as affirming broad ERISA preemption Employers increasingly challenging PBM laws across the country Bloomberg Law...

How ERISA, Medicare Part D, and their New “Mandate” Smokescreens Keep States from Cleaning Up the PBM Mess Every time a state passes a law to hold pharmacy benefit managers (PBMs) accountable — whether it’s banning spread pricing, requiring fair reimbursement, or protecting patient choice — you can bet the PBM lawyers are already in the wings, sharpening their favorite legal sword: preemption. The two blades they use most often? ERISA and Medicare Part D. But lately, the PBM

Independent pharmacies are small businesses. That shouldn’t be a controversial statement. We employ local residents, serve vulnerable...

Talking Points & Analysis of President Donald J. Trump Executive Order: LOWERING  DRUG PRICES BY ONCE AGAIN PUTTING AMERICANS FIRST ...

Michigan Advance Reporter: Marty Schladen Unions that provide health benefits to nearly a half-million workers — including many in Ohio —...

KFF Health News Reporter: Arthur Allen Ann Lewandowski knows all about pharmacy benefit managers, or PBMs, the companies that shape the...

Forbes Forbes Contributor: Rita Numerof The nation’s attention remains fixed on pharmacy benefit managers. Following a series of House...

Ohio Capital Journal Pharmacy middlemen known as pharmacy benefit managers deny claims that they’re responsible for the inflating cost of...

Los Angeles Times In 2022, an executive of a big pharmacy middleman firm acknowledged the noxious reality of its business model: It was...

Modern Healthcare Smaller pharmacy benefit managers may be having more than a moment as some health insurers and employers show the major...

The 3Axis Advisors analysis suggests PBMs’ spread pricing practices leads to employers being charged different amounts for the same...

One employer was paying about $100 for a prescription for a generic antidepressant, though it could be bought elsewhere for about $12 The...

Pharmacy benefit managers are driving up drug costs for millions of people, employers and the government. The New York Times Americans...

Drug Channels It's time for Drug Channels’ annual update of vertical integration among insurers, PBMs, specialty pharmacies, and...

The Partnership for Safe Medicines Whether it’s N95 masks, airbags, or helmets, demand for a product that the legitimate market cannot...

STAT+ News The biggest enticement that large pharmacy benefit managers offer to the employers that hire them is drug rebates — a steady...

HEALTH CARE un-covered by Wendell Potter Two newly published investigative reports, by the intrepid reporters at STAT News and The...