News
from the fight to #SaveIndiePharmacy
New York Times’ The Middlemen series
NCPA Joins Class Action Suit Against GoodRx; CVS Caremark Corp.; Express Scripts, Inc.; MedImpact Healthcare Systems, Inc.; and Navitus Health Solutions, LLC
Says the discount card company is colluding with the named PBMs to fix reimbursements
‘Rationing by inconvenience’: Health insurers count on customers not appealing denials
For many patients, the appeal process is just too much
Oklahoma takes CVS Caremark to new PBM court over alleged underpayments
Oklahoma's attorney general has accused CVS's Caremark pharmacy benefit manager unit of under-reimbursing pharmacies for prescription drugs
Pharmacy Comes Full Circle as Site of Care
Historically, pharmacists were community-based healthcare providers who made and prescribed medicines. With rapid shifts in healthcare occurring in the 20th and 21st centuries, pharmacies once again should be considered as low-cost medical homes for patients.
NEWS RELEASE: OptumRx and Walgreens Sued Over the Death of Twenty-Two-Year-Old Who Couldn’t Afford His Asthma Medication
The lawsuit alleges that on January 10, 2024, Cole tried to fill his prescription for Advair Diskus, an asthma inhaler he had taken for many years, but was told that it would cost him $539 out-of-pocket because it was no longer covered by his insurance.
DOJ sues Walgreens, alleging it ‘knowingly’ filled millions of prescriptions that lacked legitimate medical purposes
“This lawsuit seeks to hold Walgreens accountable for the many years that it failed to meet its obligations when dispensing dangerous opioids and other drugs,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the DOJ’s Civil Division.
WATCH: Arkansas Pharmacists Association, AG Tim Griffin talk pharmacy benefit manager reform
The Arkansas Pharmacists Association and Attorney General Tim Griffin held a press conference at 10:30 a.m. Thursday regarding statewide pharmacy benefit manager reform legislation.
Key Facts on Health Coverage of Immigrants
As of 2023, half (50%) of likely undocumented immigrant adults and one in five (18%) lawfully present immigrant adults reported being uninsured compared to less than one in ten naturalized citizen (6%) and U.S.-born citizen (8%) adults.
FTC Releases Second Interim Staff Report on Prescription Drug Middlemen
Report finds PBMs charge significant markups for cancer, HIV, and other critical specialty generic drugs
UnitedHealth Group ordered to pay $165 million over deceptive sales practices
UnitedHealth Group will appeal an order to pay $165 million in penalties and restitution after a judge found a business acquired by the Eden Prairie-based insurer more than five years ago used deceptive practices to sell benefits that supplement traditional health insurance in Massachusetts.
Healthcare insurance companies blamed for 'pharmacy deserts' in Minnesota
Pharmacy benefit managers are being blamed for "pharmacy deserts" being left across Minnesota as inflating drug costs squeeze out small-town pharmacies. This local news story features our friend and fellow pharmacy advocate, Deborah Keaveny, RPh of Keaveny Drug (Winsted, MN)!
Giant Companies Took Secret Payments to Allow Free Flow of Opioids
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.
Lawmakers Plot to Force Health Insurers to Sell Off Pharmacies
Bipartisan bills would make healthcare companies with pharmacy-benefit managers divest their pharmacies
UnitedHealthcare CEO’s slaying brings criticism of U.S. insurance industry to a boiling point
Greater transparency from health insurers is sought as costs of insurance continue to grow faster than wages.
Pharmacy benefit managers: What journalists need to know about the prescription drug middleman industry
It may sound counterintuitive, but firms that were created to negotiate better deals for consumers on medicines instead have sometimes driven up the costs of prescriptions — while also putting the survival of community pharmacies at risk.
Same Drug, 2,200 Different Prices
Middlemen negotiate widely different prices for prescriptions, depending on your Medicare insurance plan
Assistant Attorney General Jonathan Kanter Delivers Remarks on the Platformization of Health care
“In 2010, the big insurers promoted the narrative that single payer was a threat to Americans. Nearly 15 years later, we may well be accelerating the march to single payer, just not the kind anyone imagined in 2010, or wants today.
The moment for this discussion is now and the timing is urgent.” —AAG Jonathan Kanter
‘Not medically necessary’: Inside the company helping America’s biggest health insurers deny coverage for care
Every day, patients across America crack open envelopes with bad news. Yet another health insurer has decided not to pay for a treatment that their doctor has recommended. Sometimes it’s a no for an MRI for a high school wrestler with a strained back. Sometimes for a cancer procedure that will help a grandmother with a throat tumor. Sometimes for a heart scan for a truck driver feeling short of breath.
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.