Fierce Healthcare Reporter: Paige Minemyer A group representing thousands of pharmacies has filed an antitrust suit against Prime Therapeutics, alleging that the company colluded with rival Express Scripts to fix prices. The lawsuit was filed July 2 in Washington federal court by Protecting Access to Retail Pharmacy, LLC, an organization that operates as TRUST, LLC. The group was formed in 2023 by the National Community Pharmacy Association to support pharmacies in investigat

10 Things Your Pharmacy Can Do Right Now to Participate in PBM Reform State-level momentum is real - but legislation without participation is just words on paper. Here’s how to show up. Author: Kris Rhea, MBA Vice President of Business Development, Pharmacy Marketplace I’ve spent the last 15 years walking into over 2,500 independent pharmacies across this country. Right now, I’ve never seen pharmacists more frustrated - or more ready to fight back. The PBM issue isn’t new. Wh

Modern Healthcare Reporter: Noah Tong Health plans are thinking about shaking up how they manage pharmacy benefits, according to survey findings the Pharmaceutical Strategies Group published Tuesday. Tactics under consideration to offset rising costs for employer- and union-sponsored health plans include moving toward different drug pricing arrangements, rejecting single pharmacy benefit models and embracing third-party vendors. Pharmaceutical Strategies Group is a division o

By Allyson Snow, Esq., Founding Partner Boesen & Snow Law Of the “Three Pillars” of pharmacy survival, litigation is the pillar most pharmacy owners would rather not think about. It sounds expensive, slow, and combative, and the opposite of how most of you got into this profession. So, when a PBM sends a clawback notice, an audit demand, or a unilateral contract amendment that quietly rewrites your reimbursement, the temptation is to absorb the loss, sign the document, and mo

USA Today Reporter: Ken Alltucker A bipartisan group of lawmakers is renewing a push to target drug pricing middlemen by forcing some large pharmacy companies to break up parts of their business. It's legislation that'll look familiar to people in Tennessee – a similar bill passed the state legislature and awaits Gov. Bill Lee's signature. CVS Health has threatened to close all 134 of its pharmacy locations in Tennessee because the legislation takes aim at the pharmacy giant'

Tennessee Lookout Author: Hendrell Remus Today’s political climate is defined by soaring polarization, corporate capture and politicians who too often put donors and special interests before the people they serve. I saw it (and lived it) during my four years as Chair of the Tennessee Democratic Party. But the FairRx Act is different. In the face of a fierce corporate pressure campaign, legislators on both sides of the aisle stood up for Tennesseans struggling to afford and ac

Pharmacy Benefit Managers (PBMs) sit at the center of America's prescription drug supply chain. The three largest — CVS Caremark, Express Scripts, and OptumRx — process roughly 80 percent of all U.S. prescriptions and are owned by the same parent companies that also own major health insurers and major pharmacy chains. Federal and state lawmakers from both parties have introduced legislation that would require these companies to divest their pharmacy operations. As of this mon

Modern Healthcare Reporter: Noah Tong Key Takeaways The Federal Trade Commission and Express Scripts last month settled allegations the pharmacy benefit manager inflated insulin prices. Pharmacies say Express Scripts responded by worsening their contract terms and demanding more data about their businesses. The settlement is too ambiguous and the FTC needs to hold PBMs accountable, pharmacies contend. The FTC is poised to resolve similar charges against CVS Caremark and Optum

This March legislative madness is in full swing, and PBM Reform legislation at the state level has continued to heat up across the country. Many states have actualized savings within their Medicaid program, and are looking to help expand that success to state employee and commercial plans to help start realizing savings. We are still seeing perennial powerhouses show leadership with reimbursement reform, with a few new faces fighting the opaque “prescription tax” misinformat

Experts say the bipartisan Break Up Big Medicine Act — aimed at breaking up vertically integrated healthcare companies — faces slim chances of passing despite recent PBM reforms. MedCity News Reporter: Marissa Plescia In February, Congress finally took action to rein in PBMs via the Consolidated Appropriations Act of 2026. It included reforms like the delinking of PBM compensation from the price of a drug in Medicare Part D and more detailed reporting to plan sponsors. But t