Latest From Peter Johnson
Largest PBMs Eliminate Consumers’ Cost Sharing For Opill On Most Commercial Plans
Decisions by “big three” PBMs suggest they’re taking proactive steps to comply with potential HRSA rulemaking to require most health plans, under Affordable Care Act regulations, to cover Opill and other types of OTC birth control without cost sharing.
More States Eye Drug Affordability Boards, PBM Regulations
Some states are adding more ‘muscular attributes’ to their Rx boards, such as setting upper limits based on the pending Medicare prices, but federal ERISA legislation still limits the boards’ impact.
Lilly’s Direct-to-Consumer GLP-1 Service Likely Doesn’t Threaten PBMs
Pharmacy benefit experts say that the move is sure to improve market access for Lilly’s weight loss drugs, but they also say that the impact of the new service on PBMs is likely to be minimal.