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☆ CVS posts big earnings miss, cuts profit outlook on higher medical costs
▼ + stars: | 2024-05-01 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +3 min

CVS Health on Wednesday reported first-quarter revenue and adjusted earnings that missed expectations and slashed its full-year profit outlook, citing higher medical costs that are dogging the U.S. insurance industry. The drugstore chain expects 2024 adjusted earnings of at least $7 per share, down from a previous guidance of at least $8.30 per share. The company said its new outlook assumes that higher medical costs in its insurance business during the first quarter will persist throughout the year. Medicare Advantage, a privately run health insurance plan contracted by Medicare, has long been a key source of growth and profits for the insurance industry. Excluding certain items, such as amortization of intangible assets and capital losses, adjusted earnings per share were $1.31 for the quarter.

Persons: LSEG, Karen Lynch, Caremark, Tyson Foods, CVS's Caremark, Cuban's Organizations: CVS Health, CVS, Aetna, UnitedHealth, Medicare, LSEG, Blue, Amazon Pharmacy, Oak Street Health Locations: California

☆ Many CVS drug plans will cover over-the-counter birth control pill at no cost
▼ + stars: | 2024-04-04 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +2 min

CVS Health on Thursday said its drug plans will cover the first over-the-counter birth control pill in the U.S. at no cost for many health plan sponsors, a decision that could open the door for more people to prevent unintended pregnancies without a prescription. The company's pharmacy benefit manager, CVS Caremark, said the pill will be added to its preventive services oral contraceptives list and will be covered at zero cost for many sponsors. Pharmacy benefit managers, or PBMs, maintain lists of drugs covered by health insurance plans and negotiate drug discounts with manufacturers. It marks the first time that many U.S. residents are able to buy birth control pills over the counter, the same way they would purchase common pills like Tylenol or Advil. The drug could significantly expand availability of contraception, especially for younger women and those in rural and underserved communities who often have trouble getting access to birth control methods.

Persons: Opill, Biden, Wade Organizations: CVS, CVS Caremark, CNBC, Pharmacy, Drug Administration Locations: San Anselmo , California, U.S, Perrigo

☆ Exclusive: Ex-Truepill CEO just scored $6 million to help health plans and pharma companies ditch middlemen and work closely with patients
▼ + stars: | 2024-03-11 | by ( ) www.businessinsider.com time to read: +5 min

He's launched a new company, Foundation Health, to help them do that quickly and at a low cost. Foundation aims to make it easy for insurers to set up their own online pharmacies and pharma companies to sell drugs directly to consumers. "The main focus area for us is to help health plans disintermediate PBMs," Afridi said. Foundation Health wants to help customers ditch big PBMsFoundation's software enables a few different things. Finally, direct-to-consumer health companies can plug into Foundation's technology to power their services, instead of building their own pharmacies and hiring doctors.

Persons: Umar Afridi, disruptors, Afridi, He's, disintermediate, Garry Tan, Y, they've, pocketing, Eli Lilly's, Jack Altman Organizations: California, Cuban, Plus, Business, Foundation Health, Foundation, pharma, Alt, Liquid Ventures, Exceptional, Storm Ventures, PageOne Ventures, Federal Trade Commission Locations: drugmakers

☆ Billionaire Investor Mark Cuban: There's nothing unique about the big three PBMs
▼ + stars: | 2024-03-04 | by ( ) www.cnbc.com time to read: 1 min

Share Share Article via Facebook Share Article via Twitter Share Article via LinkedIn Share Article via EmailBillionaire Investor Mark Cuban: There's nothing unique about the big three PBMsCNBC's Morgan Brennan sits down with billionaire investor and businessman Mark Cuban to discuss his prescription drug startup Cost+ and his participation in a White House roundtable focused on the cost of healthcare.

Persons: Mark, CNBC's Morgan Brennan, Mark Cuban

Goldman Sachs lowered its rating on Estée Lauder to neutral, and its new price target calls for a slight decline going forward. Elsewhere, Daiwa raised its price target on Nvidia, which points to more than 10% upside over the next 12 months. The firm stood by its outperform rating on the chipmaker stock, but lifted its price target to $900 from $535. FLYW YTD mountain FLYW in 2024 Faucette accompanied his downgrade by lifting his price target to $30 from $27. He also lifted his price target on the stock to $40 from $30, implying upside of 24.6% from Thursday's close.

Persons: Goldman Sachs, Estée Lauder, Jefferies, Root, Daiwa, Brad Sills, Sills, — Lisa Kailai Han, Stephens, Vita Coco, Coco, Jim Salera, COCO, Lisa Gill, Gill, Louis Miscioscia, Miscioscia, Lisa Kailai Han, Piper Sandler downgrades, Piper Sandler, Mark Fitzgibbon, Fitzgibbon, Morgan Stanley downgrades Flywire, Morgan Stanley, James Faucette, Faucette, Goldman Sachs downgrades Estée Lauder, Lauder, Goldman, Yaron Kinar, Kinar, Fred Imbert Organizations: CNBC, Nvidia, Bank of America, of America, Vertex, Accenture, RSM, BDO, JPMorgan, Daiwa, Markets, Riding, AMD, Intel, York Community Bancorp, York Community, New York Community Bancorp, Travel, B2B, U.S, Jefferies Locations: York, Canada, Asia, China, Hainan, Thursday's

☆ 2 major employers said they stopped paying for weight-loss drugs like Wegovy after the drugmaker threatened to penalize them
▼ + stars: | 2024-02-16 | by ( ) www.businessinsider.com time to read: +7 min

AdvertisementThere's a little-known reason more companies aren't paying for their workers' weight-loss shots. But even at a reduced price, weight-loss drugs are budget-busting, so employers have tried to make them tougher to get. Or it could require patients to try a cheaper weight-loss drug before resorting to more expensive options. The University of Texas System, facing a bill of more than $5 million a month for its workers’ weight-loss drugs, explored saving some money by paying only for people already on the drugs. UT System ended all coverage for GLP-1 weight-loss drugs in September 2023.

Persons: —, Sam Watts, Chris Brown, ”, “, Brown, pocketing, they’ve, ” Brown Organizations: Novo Nordisk, Service, Health, CVS, University of Texas, UT, Business, Novo Nordisk doesn’t, “ Locations: Texas, North Carolina, Carolina, North

☆ Biden administration examining role of supply chain middlemen in generic drug shortages
▼ + stars: | 2024-02-14 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +3 min

They are group purchasing organizations, which broker drug purchases for hospitals and other health-care providers, and drug wholesalers, which buy medicines from manufacturers and distribute them to providers. But the Biden administration is zeroing in on other players in the drug supply chain to uncover the "root causes and potential solutions" to ongoing shortages. The Federal Trade Commission on Wednesday said it is examining the role that drug wholesalers and companies that purchase medicines for U.S. health-care providers play in shortages of generic drugs, which account for the majority of Americans' prescriptions. Group purchasing organizations and wholesalers have gotten limited attention on Capitol Hill, even as reining in high drug costs has become a key priority among lawmakers in both chambers. PBMs contend that manufacturers are responsible for high drug prices, while drugmakers say rebates and fees collected by those middlemen force them to increase list prices for products.

Persons: Biden, Doug Farrar, Cencora Organizations: FTC, Department of Health, Human Services, Federal Trade Commission, Public Affairs, CNBC, HHS, Cardinal Health, Group, Capitol, CNBC PRO Locations: U.S

☆ Here's why a top VC says healthcare investors should make growth-stage bets right now — and where he's looking for those deals
▼ + stars: | 2024-01-18 | by ( Rebecca Torrence | ) www.businessinsider.com time to read: +5 min

As a multi-stage VC fund, Lightspeed has an advantage in its exposure to both early-stage and later-stage healthcare markets, Imanbayev said. And many later-stage healthcare startups still have plenty of room to grow, he said. The first one to three years are often slow-moving for a healthcare startup, too, as it works to get its first partnerships with payers or providers, he said. But they also tend to be less risky, since later-stage startups should have revenue streams or partnerships that demonstrate their value. Lightspeed led value-based care startup Aledade's $260 million Series F in June 2023, an unusually large deal as other investors cut much smaller checks.

Persons: —, Galym, Imanbayev, I'm, There's, Farzad Mostashari, Aledade Tom Sandner, VCs, Abridge, he's, Chris Severn Organizations: Business, Lightspeed Venture Partners, Lightspeed, CVS, Health, Turquoise Health, Pharma, FDA, pharma

☆ How Mark Cuban forced the biggest US pharmacy to upend its business
▼ + stars: | 2023-12-05 | by ( Rebecca Torrence | ) www.businessinsider.com time to read: +5 min

The new program includes a set markup for medication costs, a step toward drug pricing transparency. The retailer has been facing pressure from new models like Mark Cuban Cost Plus Drugs. They've been especially focused on pharmacy-benefit managers and the lack of transparency around how much drugs cost. How Mark Cuban changed drug pricingCuban's pharmacy buys drugs directly from manufacturers and sells them to consumers at a 15% markup, plus pharmacy fees. AdvertisementBut the announcement looks to be a step in the right direction for drug pricing transparency.

Persons: —, Mark, Prem Shah, Mark Cuban, GoodRx, PBMs, Kroger, it's Organizations: CVS, Cuban, Plus, Service, Mark Cuban, Federal, US Federal Trade Commission, CVS Health, Kroger, Walgreens, Drug, Wall Street Locations: California

☆ US drug shortages are forcing ‘impossible choices’ for Americans, experts tell Senate committee
▼ + stars: | 2023-12-05 | by ( Jen Christensen | ) edition.cnn.com time to read: +7 min

Anderson Cancer Center in Houston, Dr. Jason Westin regularly witnesses the power of lifesaving cancer drugs. But because generic cancer drugs are often in shortage in the United States, he says, he and his patients have been put in a terrible position. Makers of generic drugs don’t have to share information about the supply chain, so buyers currently choose based only on price. Hernandez told the Senate committee that of the top 50 generic drugs paid for by Medicare Part D, 16 were marked up 1,000% or higher. Until there is some kind of legislation that addresses drug shortages, Wosińska and the other experts agreed, they will continue.

Persons: Jason Westin, ” Westin, that’s, they’d, Sen, Marsha Blackburn, Mike Crapo, Generics, ” Crapo, “, ”, Crapo, Inmaculada Hernandez, ” Hernandez, Dr, Marta E, it’s, ” Wosińska, Ron Wyden, ” Wyden, Hernandez, Sanjay Gupta Organizations: CNN, Anderson Cancer Center, US, Finance, Vanderbilt, Tennessee Republican, Food and Drug Administration, Westin, Skaggs School of Pharmacy, Pharmaceutical Sciences, University of California, Centers, Medicare, Medicaid Services, Brookings Institution, CNN Health Locations: M.D, Houston, United States, Nashville, Idaho, China, India, San Diego, Oregon, generics

Dec 5 (Reuters) - Eli Lilly (LLY.N) on Tuesday said its recently approved obesity treatment Zepbound is now available in U.S. pharmacies and could cost $550 a month for customers whose health insurance does not cover the drug, or half the list price. Wall Street analysts expect sales of Zepbound to reach about $2 billion in 2024, and for sales of Novo Nordisk's (NOVOb.CO) rival obesity drug Wegovy to hit around $7.5 billion. An Eli Lilly and Company pharmaceutical manufacturing plant is pictured at 50 ImClone Drive in Branchburg, New Jersey, March 5, 2021. When the U.S. Food and Drug Administration approved Zepbound in November, Lilly said it would launch after the U.S. Thanksgiving holiday. Lilly's obesity drug has the same active ingredient, tirzepatide, as its previously approved diabetes drug Mounjaro, which has been used off-label for weight loss since its 2022 launch.

Persons: Eli Lilly, Wegovy, danuglipron, Zepbound, Lilly, Mike Segar, Eli Lilly's, Patrick Wingrove, Manas Mishra, Khushi, Arun Koyyur, Alexander Smith, Bill Berkrot Organizations: Wall Street, Novo, Pfizer, Company, REUTERS, CVS, U.S . Food, Drug Administration, U.S, Thomson Locations: U.S, Branchburg , New Jersey, Indianapolis, New York, Bengaluru

☆ CVS to change how it prices prescription drugs with new pharmacy reimbursement model
▼ + stars: | 2023-12-05 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +3 min

CVS Health on Tuesday said it will revamp how it prices prescription drugs and scrap a complex model that typically sets how much pharmacies get reimbursed and what patients pay for those medications. CVS' new model could change the cost of prescription drugs for some patients, but it will not necessarily make all medicine cost less, company executives said. Lynch told CNBC: "It's a cost plus markup, plus a fee. Billionaire Mark Cuban last year launched an online pharmacy that takes a similar approach to CVS' new reimbursement model. The company, called Cost Plus Drugs, aims to drive down the price of medicines broadly by selling them at a set 15% markup over their cost, plus pharmacy fees.

Persons: Karen Lynch, Lynch, Prem Shah, markups, Billionaire Mark Cuban, Cuban Organizations: CVS Health, CVS, CNBC, Billionaire

☆ Why a giant health insurer merger is probably destined to fail
▼ + stars: | 2023-11-30 | by ( ) www.businessinsider.com time to read: +7 min

The giant health insurers Cigna and Humana are reportedly considering a merger. While they offer different kinds of health insurance, the deal is likely to face antitrust scrutiny. Still, Cigna and Humana did toy with a deal way back in 2014 before they pursued deals with other partners. Later, to sidestep antitrust scrutiny, health insurers eyed mergers with other pieces of the healthcare system outside of insurance. Cigna and Humana would face a more skeptical Justice DepartmentAny deal between health insurers the size of Cigna and Humana would have to get past the Justice Department's antitrust enforcers.

Persons: Biden, —, Justice that's, BofA, David Balto, Cigna, That's, Balto, Barak Richman, there's, Matthew Cantor, Constantine Cannon, divestitures aren't, Molina wouldn't, Cantor Organizations: Humana, Service, Reuters, Bloomberg, Street, Department, Justice, Cigna, UnitedHealth Group, Equity, Federal Trade Commission, Justice Department, Express, CVS Health, Aetna, Kindred, Biden Administration, FTC, Duke University Locations: Cigna, Aetna, Delaware

REUTERS/Andrew Kelly/File Photo Acquire Licensing RightsNov 29 (Reuters) - Cigna (CI.N) and Humana (HUM.N), two of the biggest U.S. health insurers, are in talks for what could be the largest merger announced in 2023, according to a source familiar with the matter. A Humana and Cigna combination would give the merged company the scale to rival UnitedHealth Group (UNH.N) and CVS Health (CVS.N). In July 2016, the Justice Department filed lawsuits against two health insurance mergers on the same day, saying they would lead to less competition and higher prices for Americans. Health insurers have been facing higher medical costs as people return for procedures they had put off during the pandemic. Humana in February said that it would sell its commercial business but keep its Medicare Advantage products.

Persons: Andrew Kelly, Cigna, Cigna's, Aetna, Bill Baer, Andre Barlow of Doyle, Barlow, Mazard, Bernstein, Lance Wilkes, Craig Garthwaite, Manas Mishra, Diane Bartz, Deena Beasley, Caroline Humer, Bill Berkrot Organizations: Humana Inc, REUTERS, Street Journal, UnitedHealth, CVS Health, Humana’s, Medicare, Affordable, Justice Department, Humana, U.S ., Reuters, Northwestern University, Thomson Locations: Queens , New York City, U.S, Cigna, Bengaluru, Washington, Los Angeles

☆ Drugstore closures could make pharmacy deserts even worse
▼ + stars: | 2023-11-06 | by ( Danielle Wiener-Bronner | ) edition.cnn.com time to read: +8 min

Pharmacy closures have been a problem for years. “You had a routine: You would go to a pharmacy that was geographically accessible — ideally affordable — was probably preferred for your health insurance plan. Thompson, who himself lives close to a pharmacy in the South Side, said there is now more pressure on remaining locations. But chain closures aren’t likely to lead to more business for independents, which face challenges apart from competition from national chains. Recently, pharmacy workers have been staging walkouts over working conditions they say put patients at risk.

Persons: drugstores, Jenny Guadamuz, ”, “, Guadamuz, Melvin Thompson, Thompson, We’re, Angus Mordant, Omolola Adepoju, University of Houston’s Tilman J, Douglas Hoey, PBMs, Hoey, JC Scott, ” Hoey Organizations: New, New York CNN, CVS, Walgreens, Aid, UC Berkeley School of Public Health, Health Policy, Management, Endelo Institute, Bloomberg, Getty, National Community Pharmacists Association, USC, University of, Fertitta Family College of Medicine, Rite, Walmart, Target, Pharmacy, Pharmaceutical Care Management Association Locations: New York, Chicago, United States

People walk by a CVS pharmacy store in Manhattan, New York City, New York, U.S., November 17, 2021. REUTERS/Andrew Kelly/File Photo Acquire Licensing RightsCompanies CVS Health Corp FollowNov 1 (Reuters) - CVS Health Corp (CVS.N) beat Wall Street estimates for quarterly profit on Wednesday as strength in its drugstores and pharmacy benefit management business offset higher-than-expected medical costs at its insurance unit. CVS' medical benefit ratio, or the percentage of claims paid compared to premiums collected, was 85.7% in the third quarter, compared with analysts' estimates of 85.1%. CVS' pharmacy and consumer wellness segment recorded 6% revenue growth to $28.87 billion, boosted by higher drug prices and prescription volume. The company reported an adjusted profit of $2.21 per share, beating estimates of $2.13 per share, according to LSEG data.

Persons: Andrew Kelly, Julie Utterback, Mariam Sunny, Leroy Leo, Saumyadeb Chakrabarty, Vinay Dwivedi Organizations: REUTERS, CVS Health, CVS Health Corp, CVS, Morningstar, PBMs, Revenue, Walgreens, Thomson Locations: Manhattan , New York City , New York, U.S, United States, Bengaluru

☆ Insurers and drug-industry middlemen are cashing in on the weight-loss drug frenzy
▼ + stars: | 2023-09-28 | by ( ) www.businessinsider.com time to read: +5 min

Insurers and the drug-industry middlemen they own stand to earn more as healthcare spending increases. AdvertisementAdvertisementFor US health insurers, explosive demand for new weight-loss drugs likely means bigger profits. Insurers and the drug-industry middlemen they own stand to earn more as weight-loss drugs drive up healthcare spending, BofA analysts wrote. Meanwhile, if the drugs help people live longer, insurers could earn more from higher enrollment in their health plans. As weight-loss drugs drive up healthcare spending, insurers will make more moneyWeight-loss drugs, which can cost around $1,000 a month, are driving up healthcare spending.

Persons: Li Ran, Brian Evanko, Evernorth Organizations: Trilliant Health, Bank of America Global Research, Getty, Cigna, CVS Health, UnitedHealth Group, CVS, Kaiser Family Foundation Locations: Xinhua, GLP

☆ CVS stock plunges after Blue Shield of California drops retailer's pharmacy services to save on drug costs
▼ + stars: | 2023-08-17 | by ( Annika Kim Constantino | ) www.cnbc.com time to read: +2 min

Shares of CVS Health plunged 9% on Thursday after Blue Shield of California said it will drop the company's pharmacy benefit management services and instead partner with Mark Cuban's Cost Plus Drug Company and Amazon Pharmacy to save on drug costs for its nearly 5 million members. Blue Shield will now work with five different companies to provide "convenient, transparent access to medications while lowering costs." Blue Shield CEO Paul Markovich said the plan, which is scheduled to fully launch in 2025, could save the company up to $500 million annually. Cuban's Cost Plus Drug Company will provide access to low-cost medications through retail pharmacies. Blue Shield will retain CVS Caremark for its specialty pharmacy services, which provide specialized therapies and counseling to patients suffering from complex disorders.

Persons: Mark Cuban's, Caremark, Paul Markovich, Michael DeAngelis, Centene Organizations: CVS Health, Drug Company, Amazon Pharmacy, UnitedHealth, CVS, Abarca, Blue, CNBC Locations: New York, California

☆ Launch of arthritis drug biosimilars ramps up US pressure on pricing 'middlemen'
▼ + stars: | 2023-07-25 | by ( Patrick Wingrove | ) www.reuters.com time to read: +5 min

Seven drugmakers this month launched their own versions, known as biosimilars, of AbbVie's (ABBV.N) flagship arthritis drug Humira, once the world's top-selling prescription medicine. Three have kept their list price within 5%-7% of AbbVie's, two priced at an 85% discount and two have offered both types of prices. For insured patients who are often on the hook for co-pays of 10% to 25% of the list price, the savings have been minimal. Reuters GraphicsThe Biden administration has made lowering drug prices a priority. Amgen offered 5% and 55% discounts to AbbVie's $6,922 per month Humira price tag, and both were included on drug coverage lists at two large PBMs.

Persons: Dado Ruvic, Humira, Ameet Sarpatwari, Biden, PBMs, Cigna, UnitedHealth, Amgen, Robin Feldman, Ron Wyden, Wyden, Chuck Grassley, Grassley, Patrick Wingrove, Moira Warburton, Josephine Walker, Caroline Humer, Bill Berkrot Organizations: REUTERS, Association for Accessible Medicines, Harvard Medical School, Reuters, Lawmakers, Federal Trade Commission, FTC, CVS, Biosimilars, Healthcare, Novartis, Sandoz, Reuters Graphics Reuters, University California College of the, Democratic, Republican, Thomson Locations: U.S, Humira, San Francisco, New York, Washington

☆ Exclusive: Most patients using weight-loss drugs like Wegovy stop within a year, data show
▼ + stars: | 2023-07-11 | by ( Chad Terhune | ) www.reuters.com time to read: +4 min

The annual cost of overall care for patients prior to taking Wegovy or a similar drug was $12,371, on average, according to the analysis. The costs for a similar control group of patients not taking the drugs decreased by 4% over the same period. The analysis by Prime Therapeutics, a pharmacy benefits manager (PBM), reviewed pharmacy and medical claims data for 4,255 people with commercial health plans. For the analysis, Prime Therapeutics excluded patients with type 2 diabetes to focus on obesity treatment. In trials with adults, Novo found that 6.8% of patients taking Wegovy discontinued treatment due to gastrointestinal problems and other adverse events.

Persons: Wegovy, Khrysta Baig, Patrick Gleason, Novo, aren't, Gleason, David Lassen, Lassen, Chad Terhune, Michele Gershberg, Bill Berkrot Organizations: Reuters, Vanderbilt University, Novo Nordisk, Prime Therapeutics, Therapeutics, U.S, Blue, Thomson Locations: Danish

☆ Mark Cuban's online pharmacy set to launch Humira biosimilar
▼ + stars: | 2023-07-05 | by ( Michael Erman | ) www.reuters.com time to read: +2 min

July 5 (Reuters) - Mark Cuban Cost Plus Drugs, an online pharmacy launched by the billionaire to sell drugs directly to customers at low prices, should soon begin selling Coherus BioSciences's (CHRS.O) biosimilar version of AbbVie Inc's (ABBV.N) blockbuster rheumatoid arthritis drug Humira, Cuban said on Wednesday. Cost Plus Drugs will sell Yusimry for $569.27 plus dispensing and shipping fees. Coherus introduced its Humira biosimilar in the U.S. market this month alongside offerings from other drugmakers such as Boehringer Ingelheim, Sandoz and Organon (OGN.N). Cuban's Cost Plus Drugs aims to drive down the cost of drugs broadly by selling them at a 15% markup over its cost, plus pharmacy fees. Cuban said the company hopes to provide other biosimilar drugs as well.

Persons: Humira, Cuban, Coherus, AbbVie, Michael Erman, David Holmes Organizations: Cuban, Plus, Sandoz, Cuban's, Thomson Locations: U.S, Organon, Cuban

☆ US FTC expands probe into pharmacy benefit managers
▼ + stars: | 2023-05-17 | by ( ) www.reuters.com time to read: +1 min

May 17 (Reuters) - The U.S. Federal Trade Commission said it had sought information from two privately held companies that negotiate drug rebates on behalf of pharmacy benefit managers (PBMs) as part of its probe into how PBMs affect pricing of prescription drugs. The two companies, Zinc Health Services and Ascent Health Services, are group purchasing organizations, that negotiate after-market discounts or rebates with drug manufacturers on behalf of PBMs and hold the contracts that govern those rebates. Zinc Health negotiates rebates for CVS Health Corp (CVS.N) and Ascent Health for Cigna Group's (CI.N) Express Scripts unit and Prime Therapeutics, which is a privately held PBM, the FTC said on Wednesday. PBMs act as middlemen and negotiate rebates and fees with drug manufacturers, create lists of medications that are covered by insurance, and reimburse pharmacies for patients' prescriptions. Reporting by Manas Mishra in Bengaluru Editing by Vinay DwivediOur Standards: The Thomson Reuters Trust Principles.

Both sides blame each other for high drug prices. Senator Bernie Sanders, who chairs the Senate Health, Education, Labor, and Pensions (HELP) Committee, is a fierce critic of both industries and will likely grill the executives. Optum Rx CEO Heather Cianfrocco will say manufacturers alone set the drug prices and abuse patent protections to stifle competition, her written testimony shows. Lilly, Novo Nordisk, and Sanofi all said in March they were cutting list prices by more than 70% for some insulin products. Uninsured people often have to pay full list prices, an average of $900 a month, forcing many to ration or skip doses.

☆ Eli Lilly, Novo Nordisk and Sanofi CEOs to testify before Senate on lowering insulin prices
▼ + stars: | 2023-04-21 | by ( Spencer Kimball | ) www.cnbc.com time to read: +2 min

In this photo illustration, an insulin pen manufactured by the Novo Nordisk company is displayed on March 14, 2023 in Miami, Florida. Those companies — Eli Lilly, Novo Nordisk and Sanofi — had announced in March that they will slash prices of their most widely used insulin products by 70% or more. The companies' versions of insulin cost at least $275 before the announced price slashes, Sanders noted. Novo Nordisk said its CEO looks forward to "a productive and collaborative discussion about this important issue." PBMs have come under criticism for inflating drug prices and not passing on all the discounts they negotiate to consumers.

☆ Investors Are Too Spooked by Washington’s PBM Crackdown
▼ + stars: | 2023-04-03 | by ( David Wainer | ) www.wsj.com time to read: 1 min

Pressure from Washington on pharmacy-benefit managers is having a chilling effect on Cigna stock. Middlemen known as pharmacy-benefit managers have been facing scrutiny in Washington for years, but the complexity of their system means substantial reforms continue to fail. While bipartisan momentum is once again building in Congress, a material financial impact on PBMs looks doubtful. One doesn’t have to look very far back for examples of efforts that came close but flamed out. President Donald Trump nearly hit PBMs where it would have hurt the most—by eliminating the rebates they negotiate with pharma companies—but he dropped the plan when it became clear that doing so would increase health insurance premiums, with political consequences for Republicans.

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