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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 ...
PBMs are designed to aggregate the collective buying power of enrollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs. PBMs negotiate price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and mail-service pharmacies which home-deliver ...
The FTC released a 60-page report Tuesday targeting the biggest three pharmacy benefit managers, claiming the companies hiked the prices of specialty drugs to generate $7.3 billion in revenue from ...
Pharmacy benefits managers (PBMs) are employing new strategies to squeeze independent pharmacies, even as the industry faces pressure from the federal government, which is looking for ways to curb ...
Other health care concerns covered by HEDIS are immunizations, cancer screenings, treatment after heart attacks, diabetes, asthma, flu shots, access to services, dental care, alcohol and drug dependence treatment, timeliness of handling phone calls, prenatal and postpartum care, mental health care, well-care or preventive visits, inpatient ...
Prescription drug monitoring programs, or PDMPs, are an example of one initiative proposed to alleviate effects of the opioid crisis. [1] The programs are designed to restrict prescription drug abuse by limiting a patient's ability to obtain similar prescriptions from multiple providers (i.e. “doctor shopping”) and reducing diversion of controlled substances.
But the pharmaceutical industry contends that PBM’s drive drug prices higher because they demand rebates in exchange for favorable placement on lists of drugs health insurance companies will cover.
HCUP Logo. The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).