Medicaid programs willing to boot out drug pricing middlemen
Axios
— By Bob Herman, October 8, 2019
Michigan’s Medicaid program is proposing to fire the pharmacy benefit managers that handle its prescription drug claims and negotiate prices. The state would manage drug coverage itself, starting Dec. 1.
The big picture: More state Medicaid agencies have determined that outsourcing all negotiations and operations of prescription drugs to PBMs has not produced the dramatic savings they were promised.
Details: Michigan officials said in a bulletin the state could extract bigger rebates from pharmaceutical companies and cut administrative costs if the state handled all Medicaid medication benefits, instead of the current private contractors.
- Michigan would use Magellan as its sole drug claims processor.
- A spokesperson for the Michigan Department of Health and Human Services said the proposal would save $40 million, and officials “will be reviewing the feedback carefully to determine next steps.”
- CVS Health, OptumRx, MedImpact and a handful of other PBMs stand to lose business.
Between the lines: State governments, along with pharmacists, continue to lead the crusades against PBMs.
- A recently signed California regulation will shift all Medicaid drug benefits away from PBMs by 2021, and West Virginia’s Medicaid department fired its PBMs in 2017.
Recent Posts
-
Senior Care Pharmacy Coalition (SCPC) Announces New Board Chairman, Executive Leadership Team and Board Members
WASHINGTON, July 26, 2022 — Brian Kramer, R.Ph., MBA, President of Forum Extended Care Pharmacy based in Chicago, Ill. will serve as the new Chairman of the Senior Care Pharmacy Coalition (SCPC), the Washington D.C.-based advocacy organization announced today.
-
Senior Care Pharmacy Coalition Provides Comments on the Food and Drug Administration’s Proposed Opioid Mail-Back Notice
The Senior Care Pharmacy Coalition (SCPC) has submitted a comment letter to the Food and Drug Administration (FDA) regarding the agency’s notice of a policy to require that pharmacies include a “mail-back” envelope with every prescription dispensed in an outpatient setting. The notice, which is not a formal proposal to change existing policy, concerns a policy that would modify the current Opioid Analgesic Risk Evaluation and Mitigation Strategy.
-
Check out SCPC CEO Alan Rosenbloom on the Pharmacy Podcast Network’s “PBM Reform Podcast”
SCPC President and CEO Alan Rosenbloom speaks with the Pharmacy Podcast Network about the impact of the Pharmacy Benefit Manager Transparency Act of 2022 on the Pharmacy Profession. He is joined by Michael Baxter, Senior Director of Regulatory Policy at APhA and Todd Eury with the Pharmacy Podcast Network. Listen here.
Stay in the Know
Get the latest news and updates on issues impacting the long-term pharmacy community.