News & Updates

The first target on drug prices: pharmacy benefit managers

After months of circular finger-pointing over high drug prices, lawmakers, administration officials and parts of the health care industry seem to have settled on an initial target: pharmacy benefit managers, the middlemen that health insurers and employers hire to negotiate with drug companies…Read More.

A costly PBM trick: set lower copays for expensive brand-name drugs than for generics

When the patent on a brand-name drug expires, and one or more generic versions enter the market, you’d expect consumers to pay less for the generic. That isn’t necessarily the case, thanks to the middlemen known as pharmacy benefit managers…Read More.

National LTC Pharmacy Advocacy Group: Cigna/Express Scripts Deal Heightens Salience of Gottlieb Comments Regarding PBMs and “Rigged Payment Schemes”

“Rapidly accelerating vertical and horizontal integration and growing secrecy threaten nation’s commitment to free and fair markets” – DoJ Should Reject Cigna/Express Scripts and Aetna/CVS Health…Read More.

SCPC Applauds FDA Commissioner Gottlieb’s Comments Saying PBMs Complicit in “Kabuki Drug-Pricing Constructs” and “Rigged Payment Scheme”

The Senior Care Pharmacy Coalition (SCPC) today praised Federal Drug Administration (FDA) Commissioner Scott Gottlieb’s pointed comments at an annual conference of health insurers in which he charged that pharmacy benefit manager (PBM) middlemen are complicit in “Kabuki drug pricing constructs” that expose consumers to high costs and discourage needed competition…Read More.

Comment Letter to CMS on the Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 Draft Call Letter

The Senior Care Pharmacy Coalition appreciates the opportunity to comment on the Part D provisions of the Draft Call Letter titled, “Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2019 Draft Call Letter.” The Draft Call Letter includes several proposals affecting beneficiary access to medications under the program and the ability of long-term care (LTC) pharmacies to dispense those medications and provide related consultative services…Read More

Senate bill targets pharmacy benefit managers

The Lane Report
A bill that would put the state back in charge of its Medicaid drug program has moved to the House…Read More.

Congressional opioid efforts targeting Medicare, limits on new prescriptions

A bipartisan group of senators introduced legislation Tuesday that would set a three-day initial prescribing limit on opioids for acute pain and increase recovery services and availability for addicts…Read More.

SCPC Praises Bipartisan “CARA 2.0 Act of 2018″, Stresses Importance of Recognizing Urgent Medication Needs of LTC Facility-based Seniors

National Long Term Care (LTC) Pharmacy Group Urges Congress to Follow 2016 Precedent by Exempting LTC Facilities from 3-Day Dose Provision…Read More.

Independent Pharmacies Say Drug Middlemen Are Making Them Sick

Independent pharmacy groups in several states are sick of the low insurance reimbursement rates that middlemen, known as pharmacy benefit managers, or PBMs, pay them after drugs are dispensed and they’re pushing for greater oversight of the drug middlemen…Read More.

CVS-Aetna Merger Proposal Emblematic of Growing Arms Race to Consolidate, Control Consumer Access to Health Care, Prescription Drugs

House Judiciary Subcommittee Hearing on Drug Supply Chain Should Examine Increasingly Oligopolistic Health Care System, Efforts to Monopolize Prescription Drug Marketplace…Read More.

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