Pharmacy Benefit Managers
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Caught my eye — 10/25/24
Read more: Caught my eye — 10/25/24Caught my eye .. This week I am struck by connections between 340B and pharmacy benefit managers (PBMs) in terms of being issue areas that need complete makeovers. A glow up won’t do; we’re beyond that. But the trajectory toward change is very different. PBMs and payers (maybe) benefit from the way PBMs currently work.…
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Biosimilars, Caught my eye, CMMI, Drug Prices, Employers, Healthcare Costs, Obesity, Pharmacy Benefit ManagersCaught my eye — 9/27/24
Read more: Caught my eye — 9/27/24If you haven’t trained your teams on Medicare Part D changes for 2025, hop to it. Or reach out to me. These are January 1 issues and we’re about to hit October…. Let me clear my throat. The STAT news breaking news headline read “Sanders says pharmacy benefit managers (PBMs) won’t penalize Novo for cutting…
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Caught my eye — 9/13/24
Read more: Caught my eye — 9/13/24On the pile. 46Brooklyn put out a piece demonstrating the difficulty of understanding drug prices. It is a doozy of a read. A set-aside-time-to-concentrate read. But if you are skeptical about drug pricing and want to lump it all on manufacturers, you should take the time to read it. Big picture, there is no single…
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Biosimilars, Caught my eye, Drug Prices, Employers, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Pharmacy Benefit ManagersCaught my eye — 8/16/24
Read more: Caught my eye — 8/16/24Just a quiet health policy week. Well actually, depending on your level of wonkiness, it kind of was? But let’s get into what you need to know. They’re Here! On Thursday, the Centers for Medicare & Medicaid Services released the “negotiated” prices for the initial ten Medicare prescription drug benefit drugs (Part D); these prices…
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Caught my eye — 8/9/24
Read more: Caught my eye — 8/9/24A pretty quiet week for pharma health policy but there are a few things I think you should know … The Auchincloss Venn Diagram. Brian Reid improved upon Congressman Auchincloss’s diagram and I think it provides a great way to think about pharmacy benefit manager (PBM) reform. No chicken, no egg – straight to the…
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Caught my eye — 07/26/24
Read more: Caught my eye — 07/26/24Let’s be honest, health policy has sort of taken a backseat when it comes to what we’re all tracking these days. And that’s okay. If you’ve taken a deserved timeout, let me catch you up on what caught my eye. Ice Ice Baby. The House of Representatives Committee on Oversight and Accountability released a report…
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Caught my eye — 7/12/24
Read more: Caught my eye — 7/12/24Maybe it’s summer, maybe it’s an existential crisis but none of the news of late feels all that important. Not on my bingo card. This week the Federal Trade Commission released an interim report on pharmacy benefit managers (PBMs). It was a takedown of the industry but that’s just words, not action. Unless it isn’t.…
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Getting nowhere fast
Read more: Getting nowhere fastMy mom said to never use the word hate but, honestly, I hate step therapy. I dislike prior authorization but step therapy, well I hate it. Both fall under the concept of utilization management which are barriers to access put up by payers (really pharmacy benefit managers (PBMs)) for cost or safety concerns. The idea…
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340B, Caught my eye, Drug Prices, Inflation Reduction Act, Medicare Negotiation, Pharmacy Benefit Managers, State-based ReformCaught my eye — 05/24/24
Read more: Caught my eye — 05/24/24Coulda, woulda, shoulda. On Tuesday, the Senate Judiciary committee had a hearing on prescription drug prices. It became clear that comparisons to international prices remain a focus but so is patent abuse. I am not sure that’s a fair characterization. What companies are doing is legal and I’m not sure they’d be doing their fiduciary…
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Caught my eye — 5/17/24
Read more: Caught my eye — 5/17/24Crab cakes and … horse racing. That’s what Maryland does. Mine will come with a side of Smith Island cake which I’m making tomorrow morning. Wish me luck. Odds aren’t stacked. The Centers for Medicare & Medicaid Services (CMS) announced that the Medicaid rule won’t contain the stacking provision. A little odd to pre-announce it,…
Latest news
- Caught my eye — 11/15/24
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- Caught my eye — 10/25/24
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