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Pharmacy benefit managers (PBMs) are in the crosshairs of Republicans and Democrats in Congress but have so far dodged any new litigation or reforms that had been targeted for inclusion in last ...
Anjalee Khemlani is the senior health reporter at Yahoo Finance, covering all things pharma, insurance, care services, digital health, PBMs, and health policy and politics. That includes GLP-1s ...
PBMs have used various strategies over the years to squeeze independent pharmacies, and these tactics are on the rise as the federal government takes aim at reigning in the notorious middlemen.
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
CVS Caremark was founded as MedPartners, Inc. in 1993 in Birmingham, Alabama by several local businessmen as a physician practice management (PPM) company. [1] HealthSouth, New Enterprise Associates, and Richard M. Scrushy stepped in to provide the company with early financial backing.
Patents on pharmaceuticals have also been a particular focus of criticism, as the high prices they enable puts life-saving drugs out of reach of many people. [7] Alternatives to patents have been proposed, such as Joseph Stiglitz 's suggestion of providing "prize money" (from a "prize fund" sponsored by the government) as a substitute for the ...
(The Center Square) – Legislators in Washington, D.C., have taken a number of steps over the past few days to push for insurance and pharmaceutical reforms to be passed before the end of the year.
Linda Cahn is the founder and president of a nationwide consulting firm, Pharmacy Benefit Consultants. The firm assists corporations, unions, government entities and insurance companies in improving their prescription coverage benefits and decreasing their prescription coverage costs.