Prescription Drugs That Your Insurer Objects to Paying For

Consumers have a love-hate relationship with prescription drugs.  We love the wonderful new drugs that treat and sometimes cure conditions that were once life-threatening, but we hate the sometimes-unaffordable prices of the latest drugs.  Consumers who have prescription insurance coverage are somewhat insulated from the full price of drugs, but insurers and pharmacy benefit managers […]

Can Drug Prices be Lowered?

Lowering the consumer price for a drug is in the public interest, provided that its sales margin recovers its development cost.  Pharmaceuticals do not spontaneously emerge like weeds in a field.  They are complex chemical or biological agents that are painstakingly designed and extensively tested for safety and efficacy.   That said, there are steps worth […]

Clawbacks — Another Source of Prescription Cost Overpayment

Brand and Generic drug prices show different pricing behaviors. In brand drugs, we see the effects of the 20 years of monopoly protection accorded to the first patent holder. However, the 20 years starts when the drug is invented, not when the FDA authorizes it for public use. Usually brand drugs are affordable despite noticeably […]

Apple, Amazon, and Google Involvements in the Health Care Industry

There has been much speculation about where and how quickly Apple, Amazon, and Google will join the health care industry. At $1.7 trillion in 2016, Health Care is a growth opportunity where the three tech giants are seeking footholds. Apple is shaping its health care involvement by harnessing its strength in electronics and software. It […]

Organizations Call On Congress to Encourage Prescription Competition

A large group of organizations are calling on Congress to remove regulatory barriers in order to allow generic drug makers to have access to brand name drugs for FDA testing and approval.  The bill would encourage competitive entry once brand name drug patents have expired, permitting new rivals to provide lower cost drugs to doctors […]

Anti-Consumer: Maryland House Bill 631 Would Raise Drug Prices

Senator Thomas M. Middleton, Chair Senator John C. Astle, Vice-Chair Senator Joanne C. Benson Senator Brian J. Feldman Senator Stephen S. Hershey, Jr. Senator J. B. Jennings Senator Katherine A. Klausmeier Senator James N. Mathias, Jr. Senator Nathaniel T. Oaks Senator Edward R. Reilly Senator James C. Rosapepe  Dear Senators:  The American Consumer Institute, a nonprofit educational […]

You Can Blame Pharmacy Benefit Managers for Higher Drug Prices — Real Clear Health

Pharmacy benefit managers (PBMs) administer prescription drug plans on behalf of insurers and employers. In the process, they negotiate reimbursement terms with pharmacies and drug prices with drug manufacturers. While plan sponsors face the direct financial costs of the prescription plans being offered to its members or employees, PBMs act as middlemen in the process. […]

Real Clear Health — The Middlemen in Higher Drug Prices

A consumer needs a prescription filled and goes to their local pharmacy. The pharmacist asks for your prescription benefits card, does some paperwork, gives you a generic drug and charges you according to your plan’s standard deductible, say $15. That may seem like a typical experience, but what this consumer may not have known is […]