Pharmacy Benefit Managers

GAO: states enact own regulations to address pharmacy benefit managers

April 17, 2024 - States have implemented their own regulations to address pharmacy benefit manager (PBM) operations, some of which may prove better routes than national legislation, according to a report from the Government Accountability Office (GAO). Partnering with PBMs is one way health plans can try to minimize prescription drug spending. PBMs process claims,...

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How are Medicare plans lowering drug costs for beneficiaries?

by Victoria Bailey

Affordable access to prescription drugs is a necessity for managing chronic and acute conditions and staying healthy. However, as drug costs rise, both affordability and accessibility are dwindling. Over 80 percent of surveyed adults said...

How Payers and Pharmacy Benefit Managers Work Together to Lower Costs

by Victoria Bailey

As prescription drug spending rises in the United States, healthcare stakeholders and policymakers constantly look for ways to curb costs. Many payers turn to pharmacy benefit managers (PBMs), which aim to negotiate lower drug prices with...

Payer Turns to PBM Coupon Program to Lower Prescription Drug Spending

by Kelsey Waddill

Reducing drug prices is top-of-mind for payers and employers alike. Some payers, like Capital Blue Cross, seek to make drugs more affordable by connecting members with existing coupon...

Top Threats, Priorities in Employer-Sponsored Health Plan Benefits

by Kelsey Waddill

Employers shared the main threats and priorities that they encounter as they try to manage employer-sponsored health plan benefits, according to a survey from the Midwest Business Group on Health...

Elevance Health Will Acquire Specialty Pharmacy To Treat Chronic Diseases

by Kelsey Waddill

Elevance Health has announced plans to acquire a comprehensive specialty pharmacy for patients with complex and chronic diseases. “As a trusted, lifetime health partner, the acquisition of...

Centene Announces Sale of Pharmacy Benefit Manager, Pharmacy

by Kelsey Waddill

Centene Corporation (Centene) has announced that the payer organization will sell both the pharmacy benefit manager Magellan Rx and pharmacy PANTHERx Rare.  Centene expects to make $2.8 billion...

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