The new $2,000 cap — a provision in the AARP-backed prescription drug law signed in 2022 — took effect Jan. 1 and will be adjusted each year along with the other parts of the Part D benefit. #Rx #rxcosts #oregonseniors #medicare
January 6, 2025 at 11:57 PM
The new $2,000 cap — a provision in the AARP-backed prescription drug law signed in 2022 — took effect Jan. 1 and will be adjusted each year along with the other parts of the Part D benefit. #Rx #rxcosts #oregonseniors #medicare
#PBM's were conceived as a way to manage prescriptions and hold down #RxCosts. But these middlemen have become bipartisan punching bags, accused of sucking up profits at the expense of employers, governments, and patients. #scapegoat buff.ly/fbRWtqU
Republicans and Democrats Find a Unifying Target: Pharmacy Benefit Managers - KFF Health News
Some states have considered barring companies that own a PBM from also owning brick-and-mortar pharmacies, as CVS does. Two states have followed through. A similar proposal at the federal level has…
buff.ly
September 28, 2026 at 7:00 PM
#PBM's were conceived as a way to manage prescriptions and hold down #RxCosts. But these middlemen have become bipartisan punching bags, accused of sucking up profits at the expense of employers, governments, and patients. #scapegoat buff.ly/fbRWtqU
She's damn fucking right.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about our unaffordable:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
GET YOUR PRIORITIES STRAIGHT.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about our unaffordable:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
GET YOUR PRIORITIES STRAIGHT.
April 28, 2026 at 3:32 AM
She's damn fucking right.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about our unaffordable:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
GET YOUR PRIORITIES STRAIGHT.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about our unaffordable:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
GET YOUR PRIORITIES STRAIGHT.
She's 💯 fucking right.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about OUR UNAFFORDABLE:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
PRIORITIES!! @whitehouse.senate.gov
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about OUR UNAFFORDABLE:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
PRIORITIES!! @whitehouse.senate.gov
AOC says we shouldn’t be using taxpayer money to build Trump’s ornate castle/ballroom while people are struggling to pay for healthcare and rent.
April 28, 2026 at 3:34 AM
She's 💯 fucking right.
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about OUR UNAFFORDABLE:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
PRIORITIES!! @whitehouse.senate.gov
It's disgusting and absurd for it to even be suggested, no - even be contemplated! #gross
#TRUMPballroom
#NOTourPROBLEM
what about OUR UNAFFORDABLE:
#HEALTHCARE
#costofliving
#gasprices
#foodprices
#energycosts
#childcare
#rxcosts
PRIORITIES!! @whitehouse.senate.gov
#OptumRx says its response from participating pharmacies to date has been positive. #PBM #Reimbursement #RxCosts
Optum Rx says 100% of network community pharmacies in cost-based contracts
PBMs are pivoting reimbursement models to protect pharmacies from what they say is an unsustainable status quo.
buff.ly
December 20, 2025 at 12:30 PM
#OptumRx says its response from participating pharmacies to date has been positive. #PBM #Reimbursement #RxCosts
PBMs accept the need for more #PriceTransparency. And "it should be applied across the supply chain." #MyOpinion: sounds good to me. #PBM #RxCosts
PBM trade group demands supply chain transparency for all
David Marin told a House panel that manufacturers and wholesalers should get more attention.
buff.ly
February 13, 2026 at 8:03 PM
PBMs accept the need for more #PriceTransparency. And "it should be applied across the supply chain." #MyOpinion: sounds good to me. #PBM #RxCosts
The manufacturers of all 15 drugs selected for this round have agreed to participate in the #Medicare negotiation program, along with the manufacturer of one drug selected for renegotiation. #RxCosts #CMS
CMS moves forward with 3rd round of Medicare drug negotiations
The third round of the Medicare Drug Price Negotiation Program is moving forward with full manufacturer participation.
buff.ly
March 17, 2026 at 7:01 PM
#ExpressScripts' settlement contains provisions requiring it to work with local pharmacies and disclose #RxCosts to employers annually.
Exclusive-Cigna settles FTC insulin case, commits to overhauling drug pricing
Feb 4 () - Cigna Corp's Express Scripts has settled the U. Federal Trade Commission's claims its insulin pricing practices violated antitrust and consumer protection laws, and agreed to changes aimed…
buff.ly
February 4, 2026 at 8:00 PM
#ExpressScripts' settlement contains provisions requiring it to work with local pharmacies and disclose #RxCosts to employers annually.
Employers and #PBM that violate the #ReportingRules in the new federal pharmacy benefit manager laws could end up owing $10,000-$100,000 in fines per violation per day. #ouch #ButNeeded #RxCosts
New federal PBM transparency mandates include $10K-per-day fines for employers
Employers should make sure they know who's responsible for paying the PBM noncompliance penalties, a compliance attorney says.
buff.ly
February 10, 2026 at 8:00 PM
Employers and #PBM that violate the #ReportingRules in the new federal pharmacy benefit manager laws could end up owing $10,000-$100,000 in fines per violation per day. #ouch #ButNeeded #RxCosts
Alternative funding programs shut out coverage for some very expensive #drugs. An NCOIL member said a large plan administrator in Utah offers employers an alternative funding program option. #Prescriptions #PBM #AFP RxCosts buff.ly/84LYSKP
State legislators debate regulation of 'alternative funding programs' for high-cost drugs
The "alternative funding program managers" assume patients get the drugs from charities or through other arrangements.
buff.ly
November 18, 2025 at 8:02 PM
Alternative funding programs shut out coverage for some very expensive #drugs. An NCOIL member said a large plan administrator in Utah offers employers an alternative funding program option. #Prescriptions #PBM #AFP RxCosts buff.ly/84LYSKP
The #Pfizer agreement is a part of the White House agenda to secure "most favored nation" pricing with #pharmaceutical manufacturers. Neither Pfizer nor the White House have released specific #drug prices yet. #RxCosts #StoppedClocks
Pfizer to lower some drug prices as White House builds "TrumpRX" website
Pfizer's CEO said President Trump's threat of tariffs motivated his company to take swift action.
buff.ly
September 30, 2025 at 5:31 PM
The #Pfizer agreement is a part of the White House agenda to secure "most favored nation" pricing with #pharmaceutical manufacturers. Neither Pfizer nor the White House have released specific #drug prices yet. #RxCosts #StoppedClocks
Compared to independent physician practices, drug price #markups were 6.59 times and 4.34 times as high at 340B-eligible hospitals and noneligible hospitals, respectively. #RxCosts
Some hospitals mark up generic cancer drugs 5x commercial rates: Bloomberg
Some U.S. hospitals and health systems are marking up generic cancer drugs by more than five times their commercial rates, Bloomberg reported Dec. 17.
buff.ly
December 19, 2025 at 2:00 AM
Some providers have begun spacing out #chemo doses and scheduling patients consecutively to minimize drug waste, while others are prioritizing patients most likely to benefit from treatment. #Cancer #RxCosts #Rx #shortages
Cancer drug shortages disrupt hospital supply chains, raise rationing concerns
Shortages of several generic chemotherapy drugs are straining hospital supply chains and raising concerns that cancer centers may need to ration treatment for some patients.
buff.ly
June 25, 2026 at 7:00 PM
Some providers have begun spacing out #chemo doses and scheduling patients consecutively to minimize drug waste, while others are prioritizing patients most likely to benefit from treatment. #Cancer #RxCosts #Rx #shortages
The program, #GoodRx Employer Direct, launched earlier this year with an initial focus on GLP-1s. The program also includes an employer-branded version of GoodRx’s #telehealth services. #RxCosts #EmployeeBenefits
GoodRx launches direct-to-employer program targeting drug costs - Becker's Payer Issues | Payer News
GoodRx is moving into the employer benefits market with a new program that lets companies subsidize discounted cash prices on brand-name drugs for their employees. The program, GoodRx Employer…
buff.ly
February 25, 2026 at 8:00 PM
The program, #GoodRx Employer Direct, launched earlier this year with an initial focus on GLP-1s. The program also includes an employer-branded version of GoodRx’s #telehealth services. #RxCosts #EmployeeBenefits
The drop in prescription drug prices helped pull down the broader medical care commodities index, even as medical care services — including hospital and physician charges — continued to rise. #RxCosts #MedicalCosts buff.ly/CHJQErv
Prescription drug prices post steepest annual drop since 1963
Prescription drug prices fell 3.1% over the 12 months ending in July — the steepest annual decline in more than six decades, according to the Bureau of Labor Statistics’ Consumer Price Index report released Aug. 12.
www.beckershospitalreview.com
August 13, 2026 at 11:30 PM
The drop in prescription drug prices helped pull down the broader medical care commodities index, even as medical care services — including hospital and physician charges — continued to rise. #RxCosts #MedicalCosts buff.ly/CHJQErv
Going into 2026, #PBM reforms have been picking up steam. The House passed elements of a reform under the Consolidated Appropriations Act (#CAA). Several #pharmacy groups have backed the efforts. #RxCosts #Legislation
Labor Department proposes PBM compensation disclosure rule for self-insured plans - Becker's Payer Issues
The Labor Department’s Employee Benefits Security Administration proposed regulation Jan. 29 that would require pharmacy benefit managers to disclose their compensation with self-insured group health…
buff.ly
January 30, 2026 at 9:30 PM
Going into 2026, #PBM reforms have been picking up steam. The House passed elements of a reform under the Consolidated Appropriations Act (#CAA). Several #pharmacy groups have backed the efforts. #RxCosts #Legislation
The payments stemmed from #CMS updating its Part D Formulary Reference File based on obsolete FDA data, as well as not establishing a timeline for Part D sponsors to reject these payments for newly OTC drugs. #RxCosts #Medicare buff.ly/prbPSx7
Federal watchdog claims Medicare Part D sponsors paid $587.7M for over-the-counter drugs mislabeled as prescription-only
Medicare Part D sponsors paid pharmacies $587.7 million for some over-the-counter drugs with obsolete prescription-only labels, despite CMS oversight.
www.beckerspayer.com
September 3, 2026 at 10:00 PM
The payments stemmed from #CMS updating its Part D Formulary Reference File based on obsolete FDA data, as well as not establishing a timeline for Part D sponsors to reject these payments for newly OTC drugs. #RxCosts #Medicare buff.ly/prbPSx7
In the lawsuit, the #Florida Attorney General argues that the collaboration has led #PrimeTherapeutics to adopt far lower pharmacy reimbursement rates. #ExpressScripts #PBM #Litigation #RxCosts buff.ly/Hvd1Rbe
Florida AG sues Prime Therapeutics, Express Scripts for alleged price-fixing
Florida Attorney General James Uthmeier is suing Express Scripts and Prime Therapeutics, alleging that a partnership between the two pharmacy benefit managers allows them to illegally fix prices.
www.fiercehealthcare.com
September 3, 2026 at 4:00 PM
In the lawsuit, the #Florida Attorney General argues that the collaboration has led #PrimeTherapeutics to adopt far lower pharmacy reimbursement rates. #ExpressScripts #PBM #Litigation #RxCosts buff.ly/Hvd1Rbe
The share of employers relying on the Big Three dropped from 63% in 2025 to 54% in 2026. #PBM #RxCosts buff.ly/m2kfy45
Employer use of ‘Big 3’ PBMs declines
Fifty-six percent of employer clients of “Big Three” pharmacy benefit managers — CVS Caremark, Cigna’s Express Scripts and UnitedHealth Group’s Optum Rx — are thinking about switching in the next one to three years.
www.beckerspayer.com
August 13, 2026 at 5:30 PM
The share of employers relying on the Big Three dropped from 63% in 2025 to 54% in 2026. #PBM #RxCosts buff.ly/m2kfy45
"Employers aren't facing a temporary spike in pharmacy costs but instead a consistent, year-over-year growth. We're seeing a structural shift right now, driven by these drugs." #GLP1 #RxCosts #HealthInsurance #Premiums buff.ly/THnXhIR
GLP-1s push health plan costs to 15-year high
Rising use of the weight-loss drug is fueling the fastest health plan cost growth in a decade and a half, forcing employers to rethink coverage strategies and cost management.
www.benefitnews.com
August 12, 2026 at 8:30 PM
"Employers aren't facing a temporary spike in pharmacy costs but instead a consistent, year-over-year growth. We're seeing a structural shift right now, driven by these drugs." #GLP1 #RxCosts #HealthInsurance #Premiums buff.ly/THnXhIR
"Payers [are turning] to carveouts and unbundled #PBM models as they look for more #transparency and control in how their pharmacy benefits are managed." #RxCosts
PSG report examines payers and employers’ attitudes towards GLP-1 coverage, unbundling’ PBM models
Despite steady demand for obesity medications, 49% of payers who do not currently cover GLP-1s for obesity would not do so at any price, a new
buff.ly
June 10, 2026 at 4:00 PM
"Payers [are turning] to carveouts and unbundled #PBM models as they look for more #transparency and control in how their pharmacy benefits are managed." #RxCosts
The #GoodRx membership includes access to more than 200 common generic medications for free and hundreds more for less than $10 at pharmacies nationwide. #RxCosts #PBM #SubscriptionModels
GoodRx rolls out low-cost healthcare subscription
GoodRx has launched GoodRx Companion, a $14.99 monthly subscription program focused on lowering out-of-pocket healthcare costs.
buff.ly
May 27, 2026 at 10:00 PM
The #GoodRx membership includes access to more than 200 common generic medications for free and hundreds more for less than $10 at pharmacies nationwide. #RxCosts #PBM #SubscriptionModels
Also taking effect on July 1, a new bill that expands what #Virginia #HealthInsurance plans must cover. #legislation #EssentialHealthBenefits #StateMandates #insulin #RxCosts
Gov. Spanberger signs bills to lower drug, healthcare costs
Virginia’s governor was in Fairfax County Wednesday for a ceremonial bill signing that lawmakers on both sides of the aisle say will help address rising costs. Gov. Abigail Spanberger was flanked by…
buff.ly
May 14, 2026 at 4:00 PM
Also taking effect on July 1, a new bill that expands what #Virginia #HealthInsurance plans must cover. #legislation #EssentialHealthBenefits #StateMandates #insulin #RxCosts
#OptumRx will adopt a pricing structure in which plan sponsors pay monthly, defined fees per member, as well, eliminating spread pricing. #PBM #RxCosts
‘Gone are the days’: Optum Rx to delink drug prices from fees
Optum Rx, UnitedHealth Group’s pharmacy benefit manager, said it will roll out a fee-based structure to customers in the coming years.
buff.ly
May 12, 2026 at 7:01 PM