Pharmacy Benefits Management (PBM)

Latest Headlines

Latest Headlines

Express Scripts CEO wants to resolve dispute with Anthem

The incoming CEO for Express Scripts wants to resolve a longstanding drug pricing dispute with its largest client that has morphed into a lawsuit, a confrontation that underscores the growing negotiating power for large insurers and questions Express Scripts' independent business model.

Anthem sues Express Scripts over drug prices

Anthem's public spat with Express Scripts has escalated into a lawsuit against the pharmacy benefits management company charging it with failing to pass on prescription drug savings.  

Express Scripts disputes Anthem's claim that it's owed $3B

While Anthem's pharmacy benefit manager, Express Scripts, says it is "fully committed to good faith negotiations" with the insurer amid a contract dispute between the two companies, its CEO questioned Anthem's claim of significant owed savings.  

Drug exclusions help PBMs press pharma over high-cost meds

Major pharmacy benefit managers have increasingly been playing hardball with drugmakers as health insurers and policymakers express concern over the spiraling cost of prescription medicines.

Anthem, Cigna see pharmacy benefit management opportunities in merger

In addition to adding to the insurance industry's wave of consolidation, the news of Anthem's deal to acquire Cigna also reinforced how much value the largest health insurers place in the pharmacy benefit management business.

UnitedHealth to create a next-generation pharmacy care company

Now that UnitedHealth's purchase of the pharmacy-benefit management company, Catamaran, is almost complete, company execs say that they're planning to create a next-generation pharmacy care business that's more integrated and member-focused.

Challenges, benefits abound with Aetna-Humana deal

Now that Aetna and Humana became the first two major health insurers to merge, many questions remain about how the two companies will combine their operations and what the deal will mean for the health insurance industry.

UnitedHealth to buy pharmacy benefit manager Catamaran for $12.8B

UnitedHealth Group Inc. will buy Catamaran Corp. for about $12.8 billion and merge it into OptumRx, its pharmacy benefit service, the company  announced today. The deal will likely close in the fourth quarter of 2015.

Medicare, Part D plans must scrutinize pharmacy benefit manager practices, relationships

Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.

Wal-Mart, CVS Caremark propose Medicaid drugs savings

A Medicaid reform commission in Alabama mulls whether turning the drug program over to big-box chains, such as Wal-Mart, will cut costs, The Anniston Star reported.