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How UHC’s acquisition of a popular Medicare Adv. algorithm sparked internal dissent over denied care
STAT News Reporters: Casey Ross and Bob Herman Frustration was boiling into open conflict within NaviHealth, a company that uses computer...

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12 min read


‘It’s beyond unethical’: Opaque conflicts of interest permeate prescription drug benefits
STAT+ Employers across the country — from big names like Boeing and UPS to local school systems — pay consulting firms to handle a...

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14 min read


Your Drug Rebate Check Is in the Mail…to Switzerland
Real Clear Health More than 7 million US citizens depend on insulin to live, but more than 16 percent of Americans, are rationing their...

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3 min read


Another Dispatch From the Accumulator-Maximizer Wars
Vanderbilt’s Stacie Dusetzina and colleagues explain how the ‘copay adjustment’ programs work in this week’s JAMA Internal Medicine and...

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3 min read


State Insurance Commissioners Seek Meeting With FTC On PBMs
Inside Health Policy The group representing state insurance commissioners is seeking information from the Justice Department and Federal...

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3 min read


How to Fix the National Drug Shortage
The New York Times The Times reported last month that drug shortages in the United States are approaching record levels, with thousands...

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5 min read


Bipartisan support on key panel for crackdown on pharmaceutical middlemen
The Washington Examiner Members of both parties on the House Committee on Oversight and Accountability expressed support for the...

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3 min read


Policing prescription-drug middlemen’s middlemen
Drug pricing: Antitrust regulator to probe shadowy purchasing organizations Ohio Capital Journal The Federal Trade Commission on...

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3 min read


Denials of health-insurance claims are rising — and getting weirder
Washington Post Opinion Author: Elisabeth Rosenthal Millions of Americans in the past few years have run into this experience: filing a...

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4 min read


Patients Often Lose in the Battle between Pharma and PBMs
Over the last five years, both PBMs and drug manufacturers have implemented restrictions that put more of the costs for specialty...

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9 min read


PBM landscape in for a shakeup
Axios Pro A Congressional panel unanimously advanced legislation with new transparency requirements for pharmacy benefit managers on...

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2 min read


Report: “Specialty” drugs are by far the most expensive, but classification seems arbitrary
Ohio Capital Journal The prescriptions with the most eye-popping price tags — like cancer meds that can cost more than $20,000 a month —...

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4 min read


Health Insurance Claim Denied? See What Insurers Said Behind the Scenes
Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your...

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10 min read


Prescription-drug costs in spotlight as pharmacy benefit reform advances in Senate
Drugmakers, prescription-drug middlemen trade jabs over high cost of medications MarketWatch A bipartisan effort to rein in prescription...

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3 min read


Will Senate Hearing Expose PBMs’ Unscrupulous Drug Pricing Tactics?
Forbes Today , Sen. Bernie Sanders, I-Vt., will haul executives from three insulin manufacturers and three pharmacy benefit managers...

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3 min read


Patients Lose Access to Free Medicines Amid Spat Between Drugmakers, Health Plans
Pharmaceutical companies have cut financial assistance to thwart health-plan tactics The Wall Street Journal It is getting tougher for...

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4 min read


Another powerful congressional committee is ready to take on PBMs
STAT+ House Oversight Committee Chairman James Comer plans to hold a hearing on the results of an investigation into the business...

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3 min read


Bipartisan Senate plan would regulate PBM compensation, target ‘unfair’ drug price hikes
Healio Key takeaways: The bipartisan plan would decouple pharmacy benefit manager compensation from drug prices, among other reforms. The...

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2 min read


The Implications of Pharmacy Benefit Managers Prioritizing Profit Over Patients
HCP Live Click Here to Watch the Video of Juliana Reed's Talk Juliana Reed, MS, executive director of the Biosimilars Forum, discussed...

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2 min read


What is transparency? 6 things to look for in a PBM contract
Apparently, everyone is for transparency now. So why do employers and their brokers still struggle to understand prescription drug...

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6 min read
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