Pharmacy Benefit Managers (PBMs)

Q&A: FTC’s Top Healthcare Enforcer on Pharma M&A, Company Growth and PBMs

The Federal Trade Commission has loomed large over M&A in the biopharma industry in the last two years. The antitrust regulator attempted to block Amgen’s $27.8 billion takeover of Horizon, stopped Sanofi’s licensing deal for Maze and won its effort to force Illumina to divest Grail. At the Financial Times–Endpoints News US Pharma and Biotech

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House Ways and Means Committee Unveils 2-Year Telehealth Extension Bill and Tacks on PBM Reforms

The House Committee on Ways and Means Monday night unveiled a first-of-its-kind piece of telehealth extension legislation to preserve Medicare telehealth flexibilities for two years. Telehealth lobbyists told Fierce Healthcare on the sidelines of the American Telemedicine Association annual conference in Phoenix this week that they are happy with the extension, though they prefer telehealth

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Feds Open Another PBM Probe

CMS is auditing vertically integrated Medicare Part D sponsors, including pharmacy benefit managers and payers, according to HHS’ Office of Inspector General. The agency said the probe is in response to “a wave of vertical integration between PBMs, health insurers, and pharmacies” over recent years. A common concern for vertically integrated models is inflated drug

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GAO Examines State PBM Regulation as Congress Weighs Wider Reforms

The Government Accountability Office put several states’ regulations around pharmacy benefit managers under a microscope, finding that states favor broad authority over PBMs, in a new report published Monday. Looking at five states that have enacted substantial PBM reforms — Arkansas, California, Louisiana, Maine, and New York — the GAO interviewed each state’s health plan

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