In a period of deep political polarization, politicians on both sides of the aisle agree that Americans are paying too much for pharmaceutical drugs. During the 2020 presidential election, both Joe Biden and Donald Trump made lowering drug prices a central pillar of their respective campaigns, suggesting in the next four years there could be […]
Back in September, President Donald Trump signed an Executive Order that instructed the Department of Health and Human Services (HHS) to design a “payment model” that would see Medicare Part B beneficiaries and the federal government pay “no more than the most-favored-nation price” for medication. Last week, the HHS announced it will test a Most […]
It is no secret that the cost of prescription drugs is a major concern for Americans today. Around 79% of the public agree that the price of prescription medication is unreasonable. But while much attention is focused on the role of drug manufacturers, a new report details how almost half of consumer spending on brand-name […]
The Trump administration’s recent efforts to increase transparency in hospital pricing have expectedly been met with legal push-back from the hospitals themselves. But shadowy hospital pricing is just the tip of the opaque iceberg that is driving up the costs of health care in America. To inject more competition into the industry, Congress and the […]
In every sector of the economy, transparent pricing ensures the survival of the most efficient firms and results in lower prices as firms compete for market share. There’s no reason to think the PBM industry is an exception. To read this op-ed, visit The Hill.
Consumers in Maryland are facing rapidly rising prices at the pharmacy counter, but drug makers’ prices have roughly kept pace with inflation over the last few years. What gives? It turns out that pharmacy benefit managers (PBMs), a very small number of largely unregulated companies that administer the drug plans of more than 230 million […]
If you’ve never heard of pharmacy benefits managers (PBMs), that’s the way they like it. While they administer drug plans for more than 230 million Americans, PBMs thrive on secrecy and a lack of transparency. Yet PBMs’ shady business practices deeply impact the lives of Marylanders by pushing up drug prices and limiting access to […]
Pharmacy Benefit Managers (PBMs) administer prescription drug plans for sponsors (e.g., employers and insurers), negotiate drug prices with manufacturers, and negotiate reimbursement terms with pharmacies. This ConsumerGram analyzes the structure, conduct and performance of the industry and finds that the lack of transparency in costs and prices leads to anticompetitive risks. The result can mean […]
As the new legislative session begins, Congress should demand increased transparency, require flow-through of manufacturer rebates to lower consumer prices, prohibit clawbacks, and consider giving federal agencies expanded oversight responsibilities to monitor PBMs’ practices. This op-ed explains why.
A massive, yet often unnoticed, business practice contributing to exorbitant drug prices in the U.S. may slowly be moving toward reform, according to a recent announcement by the largest practitioner. To read this op-ed, please visit Real Clear Health.