US Senate Dems seek input on alternatives that would lower drug prices
PBMs are mentioned nearly 100 times, such as:
*Increasing PBM accountability to deliver lower net effective drug costs
*Tackling PBM tactics to get higher rebates via higher prices
https://t.co/stkZLEzWi6
Attention @medmutual of Ohio:
Just processed a prescription for 30 tablets of generic Crestor for a patient who uses your God-awful insurance plan through the ACA.
Guess what your chosen PBM provider @ExpressScripts pays me to dispense this medication to your member?
If you guessed 47 cents with a $0 patient co-pay, you’d be correct.
Something strongly tells me that @medmutual is being billed by @ExpressScripts for a much higher amount.
I wonder if @ExpressScripts mail order would ship out a prescription for less than 50 cents?
Costs more for a damn stamp.
One specialty drug. $8,000 at the PBM's mail-order pharmacy. $5,000 at the hospital outpatient site your plan tried to use. The PBM denied the cheaper site for "safety." It owns the expensive one.
UnitedHealth, FTC reach proposed settlement in insulin pricing case
The tentative deal comes months after CVS reached a proposed settlement in the lawsuit alleging major PBMs are inflating insulin costs. Cigna has already settled with the FTC https://t.co/gvMD1w7rO8
It is mid-year. Who has a renewal model built on your H1 claims right now? Your PBM does. If your plan does not, the renewal is already half-decided before the first meeting.
By the time your PBM "presents" renewal terms in Q4, the terms were set by data it collected in Q1. You're not negotiating. You're being shown the result.
Your PBM's mid-year report shows aggregate numbers because aggregates hide the trend lines. Specialty creeping up. Generic efficiency slipping. Rebate-per-claim drifting. The summary is built to reassure. The detail is where your renewal is already being decided.
Pharmacies in Illinois got a share of $25 million from #PBMReform law passed in 2025, allowing them to expand services or enhance current services.
https://t.co/rTJfG2wElj
We missed Flag Day by a day. Unlike TRICARE spending, at least we're being transparent about it.
Our service members deserve accountability. Audit TRICARE spending and pass the Rx Access Act (H.R. 6400) to protect pharmacy choice from PBM interference. Take action: https://t.co/OYvKhLlse1