Tag Archive for: pharmacy benefit managers

The Federal Trade Commission plans to file lawsuits against the three largest pharmacy benefit managers over allegedly steering patients away from less expensive drugs, according to The Wall Street Journal.

Pharmacy benefit managers (PBMs) are in the crosshairs of Republicans and Democrats in Congress but have so far dodged any new litigation or reforms that had been targeted for inclusion in last month’s U.S. government budget deal.

The German drugmaker said it planned to reduce its customer-facing teams in favor of a hybrid in-person and virtual sales model by June 30, in large part because pharmacy benefit managers (PBMs) had kept branded Humira on their lists of medicines for reimbursement.

The CEOs of Bristol Myers Squibb, Johnson & Johnson and Merck testified Thursday before the Senate health committee, defending the high U.S. prices that Americans pay for prescription drugs compared to other countries based on patient value and the need to fund innovation and R&D costs.  

Recent headlines are sounding alarm bells over the highest jump in healthcare costs in a decade. The impact has the potential to cause disruptions across key market access channels: employers, health plans, and pharmacy benefit managers.

As U.S. pharmacy benefit companies face scrutiny from lawmakers and regulators, the main group representing them in Washington has nearly doubled its lobbying spend to over $15 million in 2023, a Reuters review of congressional disclosures shows.

U.S. employers facing surging costs from paying for Novo Nordisk’s Wegovy and similar obesity drugs are hiring virtual healthcare providers like Teladoc to implement weight-loss management programs, a dozen consultants, pharmacy benefit managers, analysts, and providers told Reuters.

In its most basic form, market access means ensuring patients can physically get a product. Sounds simple, right?

These are exciting times for U.S. health care: market access disruption is upon us. It’s great news for patients – and with an informed approach to access strategies, it could be great news for pharma brands, too.  

Nine U.S. states are objecting to a proposed $13.5 million settlement between Eli Lilly and a class of insulin buyers over claims that it inflated the drug’s price, saying the drugmaker is wrongly trying to use the deal to shield itself from future lawsuits by states.