NYT does deep dive into PBMs. It’s not pretty The New York Times has set out to explain how PBMs “prioritize their interests, often at the expense of patients, employers and taxpayers.” PBMs largely escape attention “because they operate in…
CMM primer defines and outlines benefits of CMM Comprehensive medication management supports population health and value-based care performance, and a recent LinkedIn post from the Population Health Alliance spells it out. CMM can improve quality outcomes and reduce costs among…
What’s happening with telehealth? Walmart's decision to shutter its health clinics and virtual care services isn’t just a blow to retail health; it has profound implications for telehealth. And it’s happening at a critical time. Optum is shutting down its…
Lawsuit: Drugmakers overcharged 340B participants millions According to a recently unsealed lawsuit from Adventist Health, some of the world’s largest pharmaceutical companies that participate in the 340B drug discount program overcharged the federal government and numerous hospitals by hundreds of…
SOTU address promises cap on OOP drug cost President Joe Biden’s State of the Union Address Thursday included some sweeping proposals, including extending a $2,000 cap on out-of-pocket drug costs to all Americans. Other proposals included expanding the number of…
Employee sues J&J over PBM costs A Johnson & Johnson employee is suing the company for allegedly violating ERISA by mismanaging prescription drug benefits. The lawsuit accuses the company of paying inflated costs for generic drugs to its PBM, Cigna’s…
GTMRx releases latest CMM evidence document The Get the Medications Right Institute has released its summary of research on comprehensive medication management (CMM). The December 2023 review, “The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A…
Unions and employers agree on one thing: PBMs Employers and unions are getting fed up with PBMs, arguing that they favor costly over less expensive options, the Wall Street Journal reports. For example, Foot Locker dropped UnitedHealth Group’s OptumRx PBM last year,…
GTMRx Institute joins business and health leaders to call for PBM reform On November 8 the GTMRx Institute joined a coalition of employers, health care providers and patient advocates in urging Congress to support strong PBM reforms this year. In…
AI based "credit score" for drugs draws criticism Narx Scores and similar tools help clinicians review controlled substance prescriptions. They influence the prescribing of painkillers much like a credit score influences the terms of a loan. The use of systems…
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