ICYMI: Pharmacy benefit managers increasingly exclude medicines from formularies, restricting patient access
By Gabby Migliara | June 1, 2020
The two largest pharmacy benefit managers (PBMs), CVS Caremark and Express Scripts, have once again increased the number of medicines on their standard formulary exclusion lists. Medicines...
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New rule makes it harder for patients to lower their out-of-pocket costs
By Holly Campbell | May 20, 2020
In the midst of increased financial insecurity for Americans due to the COVID-19 pandemic, it is shocking the Administration finalized a policy change in the 2021 Notice of Benefit and Payment...
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ICYMI: Patients saved nearly $800,000 out of pocket through innovative contracting arrangements
By Katie Koziara | April 20, 2020
Value-based programs between biopharmaceutical companies and pharmacy benefit manager Express Scripts saved $4.3 billion on medicines last year. Patients in these plans with innovative contracting...
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Retail medicine spending to remain stable share of overall health care spending through next decade
By Holly Campbell | April 16, 2020
National Health Expenditure (NHE) data projections recently released by the Centers for Medicare & Medicaid Services (CMS) indicate retail medicine spending grew 3.2% in 2019 and will continue to...
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PhRMA comments on HHS proposed rule on manufacturer cost-sharing assistance and accumulator adjustment programs
By Holly Campbell | March 3, 2020
Yesterday, PhRMA submitted comments on the Department of Health & Human Services’ (HHS) 2021 Notice of Benefit and Payment Parameters proposed rule. The proposed rule would hurt patients’ ability...
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Addressing barriers that inhibit value-based contracts
By Katie Koziara | February 21, 2020
With 56 new medicines approved by the U.S. Food and Drug Administration (FDA) in 2019 and over 8,000 medicines in development around the globe, innovative medicines are transforming the way we...
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Fact Check: HCCI analysis overstates medicine spending and prices
By Katie Koziara | February 19, 2020
A recent analysis from the Health Care Cost Institute (HCCI) on health care spending overestimates medicine spending and pricing and mischaracterizes the true drivers of health care spending in...
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Cancer medicines cost twice as much at hospitals, study finds
By Katie Koziara | January 21, 2020
Cancer medicines cost nearly twice as much in hospital outpatient facilities than in physician offices in the commercial market, according to a new study from the Employee Benefit Research...
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Nearly 50% of brand medicine spending goes to the supply chain and others
By Holly Campbell | January 9, 2020
Nearly 50% of total spending on brand medicines – the sum of all payments made at the pharmacy or paid on a claim to a health care provider – went to the supply chain and other entities in 2018,...
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New NHE data: Medicine prices declined, and hospitals were biggest driver of health care spending in 2018
By Holly Campbell | December 6, 2019
According to new data from the National Health Expenditures (NHE), retail medicine prices declined by 1% and retail medicine spending grew just 2.5% in 2018. To put that in context, hospital...
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