News Briefs

Officials in as many as seven states plus the District of Columbia are now probing PBM business practices, The Wall Street Journal reported on May 11. One of those states, Ohio, has filed lawsuits against Cigna Corp., UnitedHealth Group and Centene Corp. that accuse the companies and their PBM divisions of overcharging the state, and it is also moving to a single-PBM system (RDB 3/11/21, p. 1). In addition to Ohio’s probe, the Journal found that PBM investigations are ongoing in Arkansas, D.C., Georgia, Kansas, Mississippi, New Mexico and Oklahoma. Several states are working with the same law firm that is filing suits on behalf of Ohio. Read more at https://on.wsj.com/3bkkFdE.

When it comes to patients’ exposure to rising drug list prices, prescription drug benefit design makes a big difference, according to a study recently published in JAMA Network Open. The study examined pricing data from January 2015 to December 2017 for 79 brand-name drugs as well as a national insurance claims database. Among that commercially insured cohort, roughly half had fixed copayments and “were insulated from increases in list prices.” But the other half of patients had prescription drug benefits that included deductibles or coinsurance “and, in that cohort, out-of-pocket costs increased when manufacturers increased list prices,” the study found. What’s more, “changes in net drug prices accounting for manufacturer rebates were not correlated with changes in patient out-of-pocket spending, suggesting that increasing rebates offered by manufacturers to partially offset list price hikes are not being directly passed on to patients, even if they limit increases to total drug spending.” Read more at https://bit.ly/3o6ZwsF.

© 2021 MMIT

AIS Health Staff

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