The Mark Cuban Cost Plus Drug Co. (CPD) launched in January 2022 to distribute and home deliver prescribed generic medications to consumers. The Texas-based business seeks to reduce the prices of generic drugs by leapfrogging financial negotiators and going straight to drug companies for supply, according to a news release.1 “It’s crazy that medications are…
ACR Advocates Against VIVIO Interference in Patient Care Decisions
The ACR is advocating against policies that threaten patient access and disrupt practice workflow, including non-medical switching, tapering patients off biologics, specialty pharmacy acquisition mandates and site-of-service restrictions.
ACR Advocates Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments
In partnership with rheumatology and other specialty organizations, the ACR is working against payer and employer policies that mandate specialty pharmacy acquisition of in-office treatments.
ACR Leverages AMA Representation to Advance Rheumatology Issues
The ACR’s delegation to the AMA HOD meeting in November successfully advanced resolutions to advocate for pharmacy benefit manager transparency and expanded patient protections from step therapy protocols.
Ohio Accuses UnitedHealth’s OptumRx of Drug Overcharges
(Reuters)—Ohio’s attorney general on Monday said he had filed a lawsuit against UnitedHealth Group Inc’s OptumRx unit, saying the pharmacy benefit manager had overcharged the state nearly $16 million for prescription drugs. Ohio Attorney General Dave Yost’s lawsuit followed a probe into the extent pharmacy benefit managers (PBMs) like OptumRx had engaged in pricing practices…
The ACR’s 2018 Legislative & Regulatory Priorities
A recent Politico article outlined the looming agenda facing Congress as 2018 begins: Fund the government, raise the debt ceiling, modify spending caps, address healthcare subsidies, allocate additional funds for disaster relief, and address the status of millions of undocumented young immigrants.1 Amid all that activity, the ACR, through its Government Affairs Committee (GAC) and…
The Battle with Insurance Companies to Obtain Prescriptions
If you are a news junkie, then you know that a tick-tock is a story that relies heavily on chronology, counting down the events of the day, in order, as inexorably as the ticking clock. These types of timeline stories have become very popular in the fast-paced world of modern politics, in which readers eat…
FDA’s Gottlieb Blames Industry ‘Kabuki Drug Pricing’ for High Costs
WASHINGTON (Reuters)—U.S. Food and Drug Administration chief, Scott Gottlieb, criticized pharmacy benefit managers, health insurers and drugmakers on Wednesday for “Kabuki drug-pricing constructs” that profit the industry at the expense of consumers. The comments, made at a conference organized by a leading U.S. health insurer lobbying group, stoked speculation over what steps the administration of…
Patients Have No More Skin to Give: Dr. William Harvey Testifies on Rheumatology Issues before Senate Committee
Prior authorization treatment delays, the preferred status conferred on some drugs by pharmacy benefit managers and exorbitant co-payments were among the issues brought before the U.S. Senate Special Committee on Aging on Wednesday, Feb. 7. William F. Harvey, MD, MSc, FACR, a practicing rheumatologist at Tufts Medical Center in Boston and volunteer on the ACR…
Unwise Choices: EHRs, PBMs, Drug Costs Are Leading to Physician Burnout
My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…