As scrutiny tightens on drug middlemen and the significance of their role in spiking drug costs within Medicare Part D, health insurers are hitting back with data that shows the most expensive drugs offer the lowest rebates.
Ohio's Medicaid department is directing its managed-care organizations to quit their contracts with pharmacy benefit managers because of opaque pricing practices and strike up new arrangements with transparent vendors.
Activist investor Carl Icahn will no longer urge stockholders to vote down the proposed merger between Cigna Corp. and Express Scripts after two independent advisory firms recommended voters approve the deal.
HHS is taking steps to remove legal protections for drug rebates that favor pharmacy benefit managers. It's unclear whether the changes will actually lead to lower drug prices, experts say.
Antitrust experts and healthcare provider representatives questioned the promised benefits of a proposed merger between pharmacy chain CVS Health and insurer Aetna during a hearing before the California insurance commissioner.
David Cordani doesn't view Cigna as merely a health insurer. The Bloomfield, Conn.-based company, he said, is in the business of delivering "health services." The proposed $54 billion purchase of Express Scripts falls in line with that, he argued.
A new filing with the Securities and Exchange Commission shows why Cigna and Express Scripts decided to join forces in the wake of their breakups with health insurer Anthem.
The administration's proposal, coined American Patients First, recommended bolstering competition, allowing private plans to negotiate discounts for Medicare beneficiaries, creating incentives to lower list prices and reducing consumers' out-of-pocket spending.
Brian Griffin, the CEO of Anthem's new in-house pharmacy benefit manager, IngenioRx, has resigned to head up Diplomat Pharmacy, a specialty pharmacy services provider.
FDA Commissioner Dr. Scott Gottlieb said tweaking drug rebate laws that favor pharmacy benefit managers could be key to reducing drug prices.
A recently unsealed False Claims Act lawsuit filed in 2014 accuses CVS Health, through its pharmacy benefits manager unit, of getting lower prices on drugs with its pharmacies and failing to pass those savings on to Medicare Part D.
The deal between Centene and RxAdvance is the latest example of insurers buying or investing in PBMs to gain more control over pharmaceutical costs.