PBM
Commentary
Congress Must Prioritize Patients, Not Insurers, In Renewed Healthcare Debate
Congress has returned to Washington. Democrats are renewing their call to extend COVID-era health insurance subsidies to shield people from hefty premium increases. Just last week, some Republicans in the House joined them to pass a bill that extends these subsidies—putting the question squarely before the Senate. That approach would ...
Commentary
Why reforming PBMs is the key to lowering drug costs
If lawmakers want to make pharmaceuticals more affordable, they should look past populist policies like price controls that will only make matters worse and set their sights on reforming the Pharmacy Benefit Manager market. PBMs manage the drug benefits for insurers and negotiate discounts with drug manufacturers. You probably use ...
Commentary
PBMs’ Evolving Business Model Continues To Raise Costs On Patients
The conclusion of the longest government shutdown in history and rising political acrimony rightly receives a great deal of attention but this focus makes it easy to overlook areas where beneficial legislation is politically possible. The broad political agreement that it is necessary to reform how pharmacy benefit managers (PBM) ...
Commentary
As PBMs Drive Up Drug Prices, Silence Is Not Golden
The Trump administration has been mum in recent weeks on its “most favored nation” drug pricing plan, which broadly aims to link U.S. prices for medicines to the lowest prices in other developed countries. It’s unclear what those prices will be, how they’ll be determined, or how the administration will ...
340B
Watch Webinar with Sally Pipes on her new book, “The World’s Medicine Chest”
Watch the webinar with Sally Pipes, PRI President, CEO, and Thomas W. Smith Fellow in Health Care Policy, discussing her new book, The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy – and How to Keep It (Encounter Books). The book explores how America became the world’s leader in biopharmaceutical ...
Commentary
Learn how PBMs pocket savings intended for patients
How Long Can Pharmacy Benefit Managers Go Unchecked?
Last week, a House subcommittee held a hearing on pharmacy benefit managers and their impact on the prices patients pay for prescription drugs. The hearing speaks to voters’ concerns. Republicans and Democrats alike have identified the cost of prescription drugs as their No. 2 health care concern, according to polling ...
Commentary
Read the latest about the problems with PBMs
Insulin Lawsuits Obscure A Dirty Business
The plaintiffs say they’re fighting for patients. They’re less forthcoming about the fact that they’ve profited handsomely from the system they’re now decrying. For years, these cities and states have insisted on a cut—if not all—of the rebates that these pharmacy benefit managers extract from drug makers when negotiating over ...
Drug Pricing
NEW BRIEF: JAMA Study Justifying Drug Price Controls Deeply Flawed, Patient Health Jeopardized if Findings Implemented
SACRAMENTO – A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute analyzes a Journal of the American Medical Association (JAMA) study cited by Sen. Bernie Sanders (I-Vermont) to justify drug price controls, finding it was deeply flawed and would put ...
Health Care
NEW BRIEF: End Anti-Market Distortions in Current PBM System Would Lower Patient Costs, Increase Access to Life-Saving Drugs
SACRAMENTO – Fixing the current broken system that incentivizes pharmacy benefit managers (PBMs) to enact policies that benefit themselves and insurers at the expense of patients would lead to lower patient drug costs, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan ...
Commentary
Read latest about problems with PBMs
Decoupling PBM Fees Enhances Patient Outcomes
The three largest PBMs—Caremark (CVS Health/Aetna AET 0.0%), Express Scripts ESRX 0.0% (Cigna CI +0.7%), and OptumRx (UnitedHealth Group UNH +0.2%)—control 80% of the market and are integrated into large health insurance conglomerates. PBMs negotiate drug prices with pharmaceutical companies on behalf of insurers and manage their drug formularies. Read ...
Congress Must Prioritize Patients, Not Insurers, In Renewed Healthcare Debate
Congress has returned to Washington. Democrats are renewing their call to extend COVID-era health insurance subsidies to shield people from hefty premium increases. Just last week, some Republicans in the House joined them to pass a bill that extends these subsidies—putting the question squarely before the Senate. That approach would ...
Why reforming PBMs is the key to lowering drug costs
If lawmakers want to make pharmaceuticals more affordable, they should look past populist policies like price controls that will only make matters worse and set their sights on reforming the Pharmacy Benefit Manager market. PBMs manage the drug benefits for insurers and negotiate discounts with drug manufacturers. You probably use ...
PBMs’ Evolving Business Model Continues To Raise Costs On Patients
The conclusion of the longest government shutdown in history and rising political acrimony rightly receives a great deal of attention but this focus makes it easy to overlook areas where beneficial legislation is politically possible. The broad political agreement that it is necessary to reform how pharmacy benefit managers (PBM) ...
As PBMs Drive Up Drug Prices, Silence Is Not Golden
The Trump administration has been mum in recent weeks on its “most favored nation” drug pricing plan, which broadly aims to link U.S. prices for medicines to the lowest prices in other developed countries. It’s unclear what those prices will be, how they’ll be determined, or how the administration will ...
Watch Webinar with Sally Pipes on her new book, “The World’s Medicine Chest”
Watch the webinar with Sally Pipes, PRI President, CEO, and Thomas W. Smith Fellow in Health Care Policy, discussing her new book, The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy – and How to Keep It (Encounter Books). The book explores how America became the world’s leader in biopharmaceutical ...
Learn how PBMs pocket savings intended for patients
How Long Can Pharmacy Benefit Managers Go Unchecked?
Last week, a House subcommittee held a hearing on pharmacy benefit managers and their impact on the prices patients pay for prescription drugs. The hearing speaks to voters’ concerns. Republicans and Democrats alike have identified the cost of prescription drugs as their No. 2 health care concern, according to polling ...
Read the latest about the problems with PBMs
Insulin Lawsuits Obscure A Dirty Business
The plaintiffs say they’re fighting for patients. They’re less forthcoming about the fact that they’ve profited handsomely from the system they’re now decrying. For years, these cities and states have insisted on a cut—if not all—of the rebates that these pharmacy benefit managers extract from drug makers when negotiating over ...
NEW BRIEF: JAMA Study Justifying Drug Price Controls Deeply Flawed, Patient Health Jeopardized if Findings Implemented
SACRAMENTO – A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute analyzes a Journal of the American Medical Association (JAMA) study cited by Sen. Bernie Sanders (I-Vermont) to justify drug price controls, finding it was deeply flawed and would put ...
NEW BRIEF: End Anti-Market Distortions in Current PBM System Would Lower Patient Costs, Increase Access to Life-Saving Drugs
SACRAMENTO – Fixing the current broken system that incentivizes pharmacy benefit managers (PBMs) to enact policies that benefit themselves and insurers at the expense of patients would lead to lower patient drug costs, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan ...
Read latest about problems with PBMs
Decoupling PBM Fees Enhances Patient Outcomes
The three largest PBMs—Caremark (CVS Health/Aetna AET 0.0%), Express Scripts ESRX 0.0% (Cigna CI +0.7%), and OptumRx (UnitedHealth Group UNH +0.2%)—control 80% of the market and are integrated into large health insurance conglomerates. PBMs negotiate drug prices with pharmaceutical companies on behalf of insurers and manage their drug formularies. Read ...