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'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.
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.
Insurance companies that use prescription benefit management companies are increasingly cutting coverage of high-ticket brand-name drugs. It's not just adding to the raging drug price wars, but can also alienate members.
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.
Insurers are turning to familiar terminology in their latest effort to thwart rising prescription drug prices: Pay for performance.
Express Scripts, CVS Health and Medicaid rank among the prescription benefit managers banning specialty drugs from health plan coverage in an effort to keep costs down, Bloomberg reported.
Consumers who enrolled in plans sold on the health insurance exchanges are 59 percent more likely to use pricey specialty drugs, particularly medications that treat HIV and hepatitis C, than people with employer-based coverage, according to a new study from Express Scripts.
UnitedHealth is top dog when it comes to Medicare Part D presence in the U.S. health insurance market, according to a new study from the Kaiser Family Foundation.
Insurers in Medicare Advantage and Part D should evaluate their practices and relationships with pharmacy benefit managers to ensure better quality and member experience.