(Reuters)—Kentucky Attorney General Andy Beshear said on Thursday he had launched an investigation into allegations that pharmacy benefit managers (PBMs) had overcharged state health insurance programs for drugs and discriminated against independent pharmacies. The investigation comes against the backdrop of widespread criticism of rising costs of prescription medicines in the United States, with PBMs, middlemen…
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…
Early Activity Holds Signs of Hope for 2019 State Legislative Cycle
The 2019–2020 legislative cycle in the states holds real hope and opportunity for critical reforms to protect rheumatology practices and patients. It is important to note that because of the state legislative process, bill passage almost always comes later in the legislative session. Although the rheumatology community has not yet seen many official wins, early…
Eli Lilly Backs U.S. Proposal on Drug Rebates to Lower Costs
(Reuters)—Eli Lilly and Co. on Wednesday embraced a U.S. government proposal to end a decades-old system of rebates drugmakers make to industry middlemen, saying it could lower the cost of insulin and other prescription drugs for patients. Lilly, along with other major insulin makers, Sanofi SA and Novo Nordisk, has been under mounting pressure from…
U.S. Government Proposes Rule Overhauling Drug Industry Rebate System
NEW YORK (Reuters)—The U.S. government proposed a rule to end the industry-wide system of after-market discounts called rebates that pharmacy benefit managers receive from drugmakers, a practice that has been under scrutiny. If finalized, the rule would change a system that has been in place for decades and that increasingly has been criticized for obfuscating…
ACR’s Affiliate Society Council Reports Solid Gains in Advocacy Efforts
It’s May, and soon, most state legislatures will be adjourning for the remainder of the year. Joseph Cantrell, JD, senior manager of state affairs for the ACR, who tracks the progress of state and federal patient care legislation, reports that several states saw solid gains during 2018 state sessions, which typically run from January to…
ACR/ARHP Members Call on Congress to Restore Patients’ Voices
WASHINGTON, D.C.—The ACR hosted the 2018 Advocacy Leadership Conference in Washington, D.C., on May 16–17. Rheumatology professionals from around the country flew to our nation’s capitol to attend the conference, where advocates heard from key policymakers and spoke with lawmakers about the issues that affect the rheumatology community—and what ACR/ARHP members can do to influence policy….
FDA’s Gottlieb Eyes PBM Consolidation Impact on Generic Entry: CNBC
NEW YORK (Reuters)—The head of the U.S. Food & Drug Administration Scott Gottlieb said on Wednesday that he was concerned about the impact of deals like the CVS Health purchase of Aetna Inc. on the ability of pharmaceutical companies to block the entry of cheaper copycat drugs. As the pharmacy benefit managers and the drug…
Rheumatologists Air Frustrations with Pharmacy Benefit Managers at Annual Meeting
SAN DIEGO—Pharmacy benefit managers (PBMs) and their impact on drug prices and access to high-cost medications by the patients rheumatologists treat was a major theme at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. In one session, industry experts tried to clarify the role for prior authorizations and drug formulary policies and explored ways to constructively…
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…