Insurer and PBM tactics are shifting higher costs to patients with chronic and complex conditions

Health plans are increasingly using deductibles and coinsurance to shift more of the cost of care to chronically ill patients taking brand medicines. As data from IQVIA show, this alarming trend is...
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Holding pharmacy benefit managers accountable

State legislative sessions across the country are in full swing, and many state officials have made lowering the cost of medicine for patients a top priority. If policymakers are serious about...
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Stopping pharmacy benefit managers from “gaming the system”

People around the country say they are paying too much for their prescription medicines. State policymakers could help address this problem now. Doing so starts with stopping pharmacy benefit...
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Senate hearing to examine bipartisan reforms to rein in middlemen

Did you know that insurance companies use middlemen — known as pharmacy benefit managers (PBMs) — to decide what medicines people can get and what people pay out of pocket for those medicines?
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Minnesota lawmakers are letting PBMs off the hook, and threatening patients’ access to medicines

Middlemen don’t want patients to know how they are stacking the deck against them.
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ICYMI: PhRMA COO Lori Reilly speaks about the health care agenda for the next Congress

With a divided Congress, bipartisan action will be necessary to move the needle on health care policy. On December 7, 2022, PhRMA sponsored the Axios event, “The Post-Midterm Health Care Agenda,”...
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In their own words: Financial barriers exacerbate access challenges for insured Americans

A survey of more than 5,000 Americans conducted with Ipsos found that 30% of insured Americans say they face a financial barrier to care, such as unaffordable out-of-pocket costs or a lack of savings...
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Medicare Part D open enrollment and what recent changes mean for beneficiaries

It’s that time of year again: Medicare open enrollment! Seniors and people with disabilities who are newly eligible for Medicare, as well as current Medicare beneficiaries, can select or update their...
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New data show how insurers and middlemen shift Rx costs onto patients

There is only one place in the health care system where middlemen refuse to share negotiated prices with patients, and that’s at the pharmacy counter. A new report reveals how this harmful tactic...
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In their own words: Insured Americans struggle to navigate complex coverage

A survey of more than 5,000 Americans conducted with Ipsos found that nearly 40% of insured Americans struggle to understand what their health insurance covers.
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