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As of 2022, Caremark Rx, Express Scripts, OptumRx, Humana, Prime Therapeutics, and MedImpact Healthcare Systems were the six largest public PBMs that control 95% of the market, while the top three controlled 80% of the market. [41] As of 2024, the top 3 controlled a market of almost $600 billion. [6]
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
Prime counter-sued Kaiser and the Service Employees International Union, claiming that Kaiser owed it $100 million in unpaid medical claims and that Kaiser and the union conspired to keep Prime out of the market; [32] that suit was dismissed in 2012, [33] and Prime appealed all the way to the US Supreme Court, which declined to hear the case in ...
Medco Health Solutions, Inc. was an American Pharmacy Benefits Management (PBM) company. Medco provided pharmacy services to private and public employers, health plans, labor unions, government agencies, and individuals served by Medicare Part D Prescription Drug Plans.
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The following are settlements reached with US authorities against pharmaceutical companies to resolve allegations of "off-label" promotion of drugs. Under the Federal Food, Drug, and Cosmetic Act, it is illegal for pharmaceutical companies to promote their products for uses not approved by the Food and Drug Administration (FDA), and corporations that market drugs for off-label indications may ...
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This term is also now commonly used in commercial general liability (CGL) policies or so called "casualty" business. In these instances, the liability policies are written with a large (in excess of $50,000) self-insured retention (SIR) that operates somewhat like a deductible, but rather than being paid at the end of a claim (when a loss payment is made to a claimant), the money is paid up ...