pharmacy benefit managers

At least 20 states have settled disputes with the insurance giant since 2021 over allegations that its pharmacy benefit manager operation overcharged Medicaid programs. Why are Florida and Georgia holdouts?

The Big Three pharmacy benefit managers say they return nearly all the rebates they get from drugmakers to the employers and insurers who hire them. But most employers seem to doubt that.

Independent pharmacists say they're losing money on many prescriptions they fill. “It’s just a lot of different elements in the system all at once," says a pharmacy assistant professor at FAMU.

A rule taking effect Jan. 1 was intended to stop one set of abuses by pharmacy benefit managers, but some pharmacists say it’s enabling these price brokers to simply do new things unfairly.

Thousands of patients with autoimmune diseases who rely on Humira, with a list price of $6,600 a month, could get financial relief from new low-cost rivals. So far, the pharmacy benefit managers that control drug prices have not delivered on those savings.

At least nine bills introduced in Congress take aim at pharmacy benefit managers, the powerful middlemen that channel prescription drugs to patients. Here's what the fuss is all about.

To drive down costs, insurers are delivering high-priced infusion drugs via third-party pharmacies. Hospitals and clinics are trying to convince states to limit this practice, known as "white bagging."

Drug-makers, pharmacies, and physicians blame pharmacy benefit managers for high drug prices. Florida has already taken action. Now, Congress is finally on board, too, but will it matter?

The governor moved quickly to sign a bill that will place restrictions on pharmacy benefit managers. The House and Senate unanimously passed the measure Tuesday.

The bill is ready to go to Gov. Ron DeSantis, who during his annual State of the State address in March called for making PBM changes.