Tag:

PBM

The FTC’s Civil Action Against Powerful Pharmacy Business Managers Could Reduce the Cost of Insulin for Millions of Diabetic Patients

Insulin is a life-sustaining medication for numerous individuals with diabetes. For an extended period, many have been forced to pay inflated prices for a product that is inexpensive to manufacture. However, individuals with diabetes may now have cause for cautious optimism regarding more cost-effective treatment options. This development arises as the Federal Trade Commission (FTC) has decided to address one aspect of the system responsible for the high cost of insulin. The FTC initiated legal proceedings against the three largest pharmacy benefits managers (PBM) on September 20, 2024. The action was taken in response to alleged unfair and anticompetitive rebating practices that were purported to have artificially elevated the list prices of insulin medications.

Trump Administration’s Proposal to Update Anti-Kickback Safe Harbors Gives Patients Drug Price Relief at the Pharmacy Counter

On January 31, 2019, the Trump administration proposed yet another regulation in efforts to control rising prescription costs for Americans. If the regulation becomes final, drug manufacturers and Pharmacy Benefit Managers (“PBM”) will no longer be able to harbor from Anti-Kickback violations when negotiating discounts with Medicare and Medicaid managed care programs. The Administrations, continuing the tone of transparency, will instead provide Medicare Part D beneficiaries with the ability to receive discounted prices at the pharmacy counter. The administration hopes this will allow patients to not endure high out-of-pocket costs by purchasing medications at a more affordable price necessary to sustain their health.