Some Possible Witnesses For Next Month's Hearing on the CVS and Aetna Merger
Next month, Judge Richard Leon will hear from witnesses about whether the merger of the PBM and pharmacy CVS and the health insurance company Aetna is good for consumers. While the Department of Justice approved the acquisition with only limited divestitures, Judge Leon is skeptical of the deal, and wants to gain insights from witnesses who opposed the merger. He still has not decided whether to approve the transaction. Three organizations have been recognized as amicus curia
The Maryland Legislature's Approval of a Prescription Drug Affordability Board And What It Means
Last week, the Maryland legislature concluded its 2019 session. As a part time legislature, they only meet for three or four months per year, and this results in a whirlwind of activity. But before the legislators adjourned, they passed an important bill that will lower drug prices: they approved the establishment of a Prescription Drug Affordability Board that could cap payments for extremely expensive medicines. The struggle was not easy. Many drug companies lobbied against
Federal Judge Orders New Hearing on CVS and Aetna Merger, Wants to Hear from Critics of the Deal
The federal judge currently considering the merger of the pharmacy and PBM CVS and the health insurance company Aetna has ordered a hearing to hear from critics of the $69 billion merger. Judge Richard Leon of the U.S. District Court for the District of Columbia said that he wants to listen to organizations and individuals who opposed the transaction. The merger closed in November 2018, but the judge criticized the Department of Justice's approval for failing to adequately pr
Consumer Groups Submit Comments in Support of HHS's Proposed Rule to Lower Drug Prices By Elimin
This Monday, April 8th, consumer groups submitted comments in support of the Department of Health and Human Services's proposal to lower prescription drug costs by eliminating the safe harbor rule for most rebates paid to pharmacy benefit managers (PBMs) and organizations, and requiring that the remaining rebates be passed on to consumers at the point of sale. The comments were submitted on behalf of Consumer Action, Consumer Federation of America, Consumer Reports, NETWORK L
House Energy and Commerce Investigation Subcommittee Rips Into Drug Companies, PBMs Over Rising Insu
It has been a busy week on Capitol Hill. On Tuesday, the Senate Finance Committee held its first ever hearing on PBMs. And yesterday, Wednesday, April 10th, the House Energy and Commerce's Investigation Subcommittee held a second hearing on the rising costs of insulin (which is used to treat diabetes) and who is responsible for this crisis. For two and a half hours, representatives attacked drug companies and PBMs for evading responsibility and blaming each other for rising p
CVS Denied A Patient the Drugs She Needed. Fortunately She Was Able to Fight Back
Pharmacy benefit managers (PBMs) wield immense power over the prescription drug supply chain and often interfere with decisions that should be between doctors and patients. In many cases, they even deny patients medicines they need because the medicines are not covered, or too inexpensive, or for other, even more arbitrary reasons. A recent report from Tarbell.org, a nonprofit journalism site, found that the PBM CVS Caremark rejected a Delaware woman's appeal to receive a pre
Senate Finance Committee Examines How PBMs Cause Higher Drug Prices
This morning, Tuesday, April 9th, the Senate Finance Committee held its first ever hearing on pharmacy benefit managers (PBMs) and how they contribute to higher drug costs. In a two and a half hour session, Senators asked tough questions of five PBM executives, criticized their business practices, and demanded more transparency and accountability. The witnesses before the Committee were the CEOs of five of the country's biggest PBMs. They were: Dr. Steve Miller, Vice Presiden
Questions for Tomorrow's Senate Finance Committee Hearing on PBMs and Drug Prices
Tomorrow, Tuesday, August 9th, at 10:15 AM, the Senate Finance Committee is holding its third hearing on rising prescription drug prices and the factors that contribute to them. It is called "Drug Pricing in America: A Prescription for Change, Part III" and will focus specifically on pharmacy benefit managers (PBMs) and how they are a major cause of increasing drug costs. We hope the Senators will ask tough questions and not let PBMs off the hook. Below are some suggested que
Senators Grassley, Wyden Send Letters Demanding Answers from PBMs About Their Role in Rising Insulin
Senator Chuck Grassley (R-IA), chair of the Senate Finance Committee, and Senator Ron Wyden (D-OR), ranking member of the Finance Committee, have sent letters to the three largest pharmacy benefit managers (PBMs) demanding information and documents about how they contribute to rising insulin prices. The letters were sent to Express Scripts, CVS Caremark, and OptumRx, in preparation for the upcoming April 9th Finance Committee hearing on PBMs and drug costs. According to a sum
More State Actions Are Likely Coming Against PBMs
In January, Ohio Attorney General Dave Yost announced an investigation of PBMs that contract with Ohio's state agencies to manage drug benefits. In March, he filed a lawsuit against the PBM OptumRx for overcharging the state government for generic drugs, seeking $16 million in damages. Now, court filings suggest that more legal actions against PBMs are on the way. Court exhibits filed on March 15th in Franklin County Common Pleas Court are the first evidence. According to the
