Federal Trade Commission’s Post

The FTC’s interim report lays bare the impact of consolidation among pharmacy benefit managers. The three largest PBMs filled nearly 80% of all prescriptions in the U.S., collecting a disproportionate amount of specialty drug revenue and steering patients to their own pharmacy subsidiaries, and too often increasing costs for patients. This report adds to recent compelling data from a Milliman report on the impact of IRA’s pricing setting provisions, due to the role PBMs play in driving costs for patients, as well as investigative pieces from The New York Times on PBMs and The Wall Street Journal on mail-order drugs. This accumulating evidence from independent sources supports Sanofi's longstanding assertion in our Pricing Principles Report: PBM business tactics negatively impact patients since the extensive discounts, rebates, and fees we pay are not translated into affordable access. Manufacturers, including Sanofi, undoubtedly have a role in keeping costs low for patients. However, we can’t make the system work better for patients without removing perverse incentives through policy changes and a good faith effort from the entire value chain. View our full Pricing Principles Report here: https://lnkd.in/gyVs35x5 Thank you to the authors of the Milliman report Maddie Cline, Michelle (Klein) Robb, and Katie Holcomb, New York Times authors Reed Abelson and Rebecca Robbins, and Wall Street Journal author Jared Hopkins for your work bringing these issues to light.

"Specialty drug prescriptions and costs are on the rise in the United States and accounted for over two-thirds of new FDA approvals in the past three years." The factors driving drugflation continue to surge, with costs associated with specialty drugs alone growing annually 15 to 20%. There is no stopping the skyrocketing cost of prescriptions, but the right strategies can empower you to control them. The 2023 Specialty Drug Survey highlights some of the strategies employers are leveraging with their pharmacy benefit partners, like a PBO, to mitigate the rising cost of pharmacy benefits. #employeebenefits #drugflation #pharmacybenefits

"The Federal Trade Commission today published an interim report on the prescription drug middleman industry that underscores the impact pharmacy benefit managers (PBMs) have on the accessibility and affordability of prescription drugs. The interim staff report, which is part of an ongoing inquiry launched in 2022 by the FTC, details how increasing vertical integration and concentration has enabled the six largest PBMs to manage nearly 95 percent of all prescriptions filled in the United States." Learn more reading "FTC Releases Interim Staff Report on Prescription Drug Middlemen" #drugmiddleman #drugs #middleman #prescriptions #pharmacybenefitmanagers #pharmacy #yourhealthmatters #buylocal #shoplocal #yousaveonmeds

👀 The 𝗕𝗶𝗱𝗲𝗻 𝗮𝗱𝗺𝗶𝗻𝗶𝘀𝘁𝗿𝗮𝘁𝗶𝗼𝗻 is taking a stand against high prescription drug costs. Negotiations are set to begin with 𝘮𝘢𝘫𝘰𝘳 𝘮𝘢𝘯𝘶𝘧𝘢𝘤𝘵𝘶𝘳𝘦𝘳𝘴 to cap prices on ten key medications for 𝗠𝗲𝗱𝗶𝗰𝗮𝗿𝗲 𝗿𝗲𝗰𝗶𝗽𝗶𝗲𝗻𝘁𝘀. This historic move could change the lives of those forced to make tough choices due to 𝘪𝘯𝘧𝘭𝘢𝘵𝘦𝘥 𝘥𝘳𝘶𝘨 𝘤𝘰𝘴𝘵𝘴. 💰 ⚖️ Despite legal challenges from the 𝘱𝘩𝘢𝘳𝘮𝘢𝘤𝘦𝘶𝘵𝘪𝘤𝘢𝘭 𝘪𝘯𝘥𝘶𝘴𝘵𝘳𝘺, the administration is determined to balance fair profit for companies with affordable access to life-saving treatments for the American people. 📲 𝗖𝗹𝗶𝗰𝗸 𝘁𝗵𝗲 𝗹𝗶𝗻𝗸 to read more! #healthcarereform #medicare #prescriptiondrugcosts #potus #ssareps

In the complex web of healthcare pricing and prescription drugs, the idea of a low-net-cost formulary has reemerged as a critical player. In this article, Scott Wert and I break down how to find the balance between cost and the potential to benefit the greatest number of patients in the current healthcare landscape.

Prescription drug costs are a major concern among employer groups of all sizes. As new drugs are introduced and costs continue to increase, self-funded plans are using alternative funding strategies through Pharmacy Benefit Managers (PBMs) to maintain medication benefits while achieving a meaningful cost savings to participants. Read more in our recent blog discussing the role of PBMs and Alternative Funding Programs, and the regulatory limitations and permissions employers should consider: https://lnkd.in/duVs7Nr9 #pharmacy #pharmaceutical #pharma #prescriptiondrug #drugprices #employer #employeebenefits #selffunded #healthplans #pharmacybenefits #PBMs

Visante's Top 10 Issues Facing Health System Pharmacy for 2024 PRESCRIPTION DRUG PRICES AGAIN A CHALLENGE IN 2024 By Jim Jorgenson, Wendy Weingart, and Kasandra Botkin (Chambers) Drug prices are again a pain point for 2024 and remain challenging for pharmacy and health systems. Health system leaders should consider the impact on their organization created by the Inflation Reduction Act, biosimilar specialty drugs, Pharmacy Benefit Managers (PBMs), drug shortages, and market disruptors, such as RxPass, Civica Rx, and Mark Cuban Cost Plus Drugs. We also recommend specific strategies to mitigate the rising costs and find opportunities to improve financial performance. Click here for the full article - https://lnkd.in/gXT4sNey and here for the entire 2024 edition of Visante's Top 10 - https://lnkd.in/giKQywh5 #drugprices #pharmacycosts #highperformingpharmacy

“For the first time, Medicare will be able to negotiate prices directly with drug companies, lowering prices on some of the costliest prescription drugs.” Great list of life saving medications included in the first round of negotiations between Medicare and the pharmaceutical industry. The pricing negotiation process is supposed to be done by September 2024, but the prices won’t go into effect until January 2026. Pretty big lag when we’re talking about people’s health! My big takeaways 1) cardiovascular and diabetes medications make up a huge portion (20 %) of Medicare Part D expenditure 2) the process for pricing reform will take some time 3) more people under Medicare should be able to afford their medications over the coming years My questions 1) How will the change in revenue from Medicare change the pricing on private insurers and other countries? 2) Will we see long term changes in novel medicine development? 3) Will there be a push by pharma to increase patent length on novel medications? https://lnkd.in/eeqZVukX

There is a common misconception that Pharmacy Benefit Managers (PBMs) drive the high-cost of prescription drugs. They actually do the opposite. PBMs exist to make prescription drugs more affordable for consumers and employers. Pharmaceutical companies are directly responsible for how drugs are priced in this country. I hope you’ll take time to read this op-ed written by my colleague David Joyner, president of CVS Health’s PBM business CVS Caremark. David talks about how Caremark brings value to the people we serve by working directly with drug companies, driving competition and negotiating discounts to help make prescription drugs more accessible and affordable.   Through new innovations like True Cost, we drive greater transparency around the true net cost of prescription drugs that pass savings on to consumers. This is what we uniquely can do at scale. https://bit.ly/4cEruVD