Tag: Pharmacy Benefit Managers (PBMs)

WASHINGTON – The Federal Trade Commission has published an interim report that underscores the negative impact pharmacy benefit managers have on accessibility and affordability of prescription drugs.  The FTC’s report, which is part of an ongoing inquiry launched in 2022, details how increasing vertical integration and concentration has enabled the six largest PBMs to manage nearly 95% of all prescriptions filled in the United States. This market structure has allowed PBMs to...

WASHINGTON – The Federal Trade Commission has published an interim report that underscores the impact pharmacy benefit managers have on accessibility and affordability of prescription drugs.  The FTC’s report, which is part of an ongoing inquiry launched in 2022, details how increasing vertical integration and concentration has enabled the six largest PBMs to manage nearly 95% of all prescriptions filled in the United States. This market structure has allowed PBMs to profit at...

ALEXANDRIA, Va. – The National Community Pharmacists Association has released a new TV ad as part of its ongoing campaign to push lawmakers to enact pharmacy benefit manager reform. The ad, titled PBM Career Day, shows a PBM executive struggling to explain his job to curious children. The executive shares that he doesn’t make, prescribe or provide drugs, but he does decide what drugs patients receive and what he pays for them. "PBMs and the massive health insurance companies that...

PHOENIX and PITTSBURGH – StateServ, a provider of DME benefit management solutions to the post-acute care market in the U.S., has acquired Delta Care Dx, a provider of integrated pharmacy benefit management, mail order prescription, sterile/non-sterile compounding and clinical pharmacist consulting to the hospice and palliative care markets, in a move that forms the industry's first scaled DME and pharmacy solution.  The companies say their unique combination forms a leading care-at-home...

ALEXANDRIA, Va. – The National Community Pharmacists Association is throwing its support behind another class action lawsuit filed against UnitedHealth Group and its pharmacy benefit manager, OptumRx. The lawsuit, announced by the law firms Berger Montague PC and Cohen & Gresser LLP, claims that UnitedHealth Group and OptumRx have been assessing pharmacy DIR fees in violation of federal antitrust laws and state laws governing contracts. “After years of abuse at the hands of big insurance...

ORLANDO, Fla. – The National Community Pharmacists Association is creating a limited liability company called TRUST LLC to investigate and, when appropriate, litigate or arbitrate on behalf of community pharmacies to recover pharmacy direct and indirect remuneration fees.  The NCPA believes DIR fees were assessed by the PBMs and insurance plans in violation of federal antitrust law and state contract laws.  “PBMs shouldn't be able to make assessing junk DIR fees against...

ALEXANDRIA, Va. – A new class action lawsuit filed against Caremark is the latest move in the fight to rein in the “revenue grab” of pharmacy benefit managers, says the National Community Pharmacists Association.  The NCPA is not a named party in the lawsuit, which was filed Sept. 27, but has helped educate the law firms behind it, says Anne Cassity, senior vice president of government affairs at association.  “These (pharmacy direct and indirect remuneration...

WEST LINN, Ore. - The Oregon State Pharmacy Association and the National Community Pharmacists Association support the Oregon Health Authority’s recommendation that the state “should enact legislation that focuses on patient and pharmacy protections and increasing transparency in the prescription drug supply chain.” The recommendation, which was part of the state’s recent audit report on PBMs, builds on a 2022 report OSPA released in collaboration with 3 Axis Advisors that...

NEW BEDFORD, Mass. - Enos Home Medical has expanded its footprint in northern Massachusetts and reinforced its focus on the hospice market with a recent acquisition of “significant DME assets” in the area, says Jon Enos.  The acquisition better positions Enos Home Medical to “meet current dynamic market conditions and today’s ever-changing medical landscape,” the company says.  “We are excited to be able to reach even more hospice patients in the...

WASHINGTON – The National Community Pharmacists Association welcomes the passage of the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act, H.R. 3561, by the House Energy and Commerce Committee. The PATIENT Act, which passed the committee 49-0, includes several provisions vital to lowering prescription drug costs and bringing transparency to the practices of pharmacy benefit managers, the NCPA says. “Patients and community pharmacies have been advocating...