New JAMA Viewpoint on Pharmacy Incentives

Third-party entities like pharmacy benefit managers (PBMs), wholesalers, and insurers play a significant role in influencing prescription drug costs. PBMs negotiate rebates with manufacturers, potentially raising medication prices. They also use spread pricing, profiting by reimbursing pharmacies less than they receive from insurers. Wholesalers, distributing drugs in bulk, and insurers with tiered cost-sharing structures can also contribute to increased patient expenses. Read more about the complex web of prescription drug pricing in the U.S. and how it impacts consumers' wallets: https://lnkd.in/eAVQ6-VP #PharmacyBenefitManagers #PrescriptionPricing #HealthcareCosts #DrugRebates #SpreadPricing # #PatientExpenses #USHealthcare #HealthcareEconomics #Business #Health #Healthcare

Drug shortages threaten patients’ access to medications and are associated with adverse #healthoutcomes and increased costs. The authors propose the implementation of a value-based reimbursement system to incentivize provider selection of multi-source products manufactured in more resilient supply chains. #value #drugdevelopment #pricing #patientoutcomes #outcomesresearch #heor #healtheconomics #marketaccess #reimbursement #drugpricing #generics #amcp #managedcare #pharma #patientaccess #medicare #healthpolicy #valuebasedcare #valuebasedcontracting

📢 **The Urgent Need for Health Plans to Incorporate an International Pharmacy Procurement (IPP) Program** 📢 The skyrocketing demand for weight-loss drugs like Ozempic and Wegovy highlights a critical issue: the need for comprehensive health plans to manage rising costs and ensure patient well-being. In light of recent discussions around drug pricing and accessibility, it's more important than ever for health plans to incorporate an International Pharmacy Procurement (IPP) program. This approach can balance cost-efficiency with the necessary oversight to manage potential side effects and long-term impacts of these medications. Read more about the issue [here](https://lnkd.in/exmbtpjf). #Healthcare #PharmacyBenefits #PatientCare #HealthPlans #IPP #DrugPricing #Ozempic #Wegovy

Recent investigations by Congress and government agencies have spotlighted problematic practices in the PBM industry. PBMs, which manage prescription drug benefits for over 200 million Americans, are under fire for practices that often increase costs for employers and employees without delivering corresponding value. Key findings include: 💊 Favoring higher-priced drugs with larger rebates. 💊 Charging multiple times the wholesale price of drugs. 💊 Pushing patients towards more expensive medications. Innovative PBMs like BeneCard PBF are stepping up with fairer, patient-centered approaches. We prioritize member health over profits, ensuring transparency and genuine cost savings. Is your PBM putting your needs first? https://lnkd.in/eXdEZv27 #Healthcare #PharmacyBenefits #PBM #PatientCare #CostSavings #BeneCardPBF

Pharmacies have been seeing a decrease in growth and many have even been closing. One of the reasons that pharmacies have been closing is due to Pharmacy Benefit Managers (PBMs). PBMs are intermediaries between insurers and pharmacies that negotiate drug prices and reimbursement rates. Often times, PBMs negotiate rates that are not suitable for smaller pharmacies, squeezing their profit margins. Additionally, PBMs sometimes require patients to use specific pharmacies, often their own or those with which they have contracts, further reducing business for independent pharmacies. #Pharmacy #PharmLife #PharmacyTech #Pharmacist #PharmacyTechnician

Specialty drugs account for over 50% of pharmacy spend, but do you know where each dollar goes? 💸 Understanding the Flow of the Specialty Drug Dollar is critical for self-insured employers and benefit consultants aiming to manage costs without sacrificing patient outcomes. From manufacturers to PBMs, every link in the chain impacts your bottom line. Transparency is key! 🔍 Want to dive deeper into managing specialty pharmacy costs? Watch the video explainer for practical insights. 📊 Click to Watch: https://lnkd.in/gXhqy-F8 #PharmacyBenefits #SelfInsured #SpecialtyDrugs #HealthcareCostManagement #BenefitsConsultants #EmployerSolutions #CPBS #PBIA #TransparentRx

*** Breaking News: Federal Health Committee Rejects Confidential Drug Pricing Proposal *** 🚨 In a pivotal decision, the Federal Health Committee has opposed the German government's proposed regulation for the confidentiality of reimbursement amounts for new medications, as outlined in the draft Medical Research Act. For tomorrow's Federal Council discussion, the leading Health Committee and other committees have recommended eliminating the proposed confidentiality rule for drug prices. The draft legislation, not requiring Federal Council approval, suggested keeping negotiated reimbursement amounts between health insurers and pharmaceutical companies confidential at the manufacturer's request. 💊 The committee's recommendations highlight concerns over increased opacity and the substantial bureaucratic and financial burden that would come with differential compensation, questioning the actual benefits. 🗣 It remains to be seen whether the Federal Council will align with the committee's recommendation and reject the confidentiality regulation. Stay tuned for more updates! #Healthcare #Pharma #Transparency #PolicyUpdate

2023 Fresenius Kabi research shows that Directors of Pharmacy identify drug shortages as the top issue that their institution is facing. As a manufacturer of essential medicines, we share their concerns, have made significant investments in the U.S. and are at the forefront of legislation and solutions that work to resolve the issue of drug shortages – paving a path forward where every patient has access to the medication and care that they need. Find out what we’re doing to bring #MoreSupply to America: https://lnkd.in/e79iJiZu #EndDrugShortages #MoreInAmerica

Specialty drugs account for over 50% of pharmacy spend, but do you know where each dollar goes? 💸 Understanding the Flow of the Specialty Drug Dollar is critical for self-insured employers and benefit consultants aiming to manage costs without sacrificing patient outcomes. From manufacturers to PBMs, every link in the chain impacts your bottom line. Transparency is key! 🔍 Want to dive deeper into managing specialty pharmacy costs? Watch the video explainer for practical insights. 📊 Click to Watch: https://lnkd.in/gXhqy-F8 #PharmacyBenefits #SelfInsured #SpecialtyDrugs #HealthcareCostManagement #BenefitsConsultants #EmployerSolutions #CPBS #PBIA #TransparentRx

Ahead of the two-year anniversary of the #IRA, CMS announced the #maximumfairprices of the first 10 drugs selected for #Medicare drug price negotiation drugs. Reach out to Milena Sullivan or other #AvalereExperts to understand exactly what this announcement means for your organization and industry: https://lnkd.in/epbJHmHJ #healthpolicy #healthcare #drugpricing #MFPs