Pipeline Preview (April 2006)

When CMS begins negotiations for physician-administered drugs under the Inflation Reduction Act, providers, including those whose services are covered by commercial insurance, could see lowered reimbursement.

Whether Express Scripts wins its unique defamation lawsuit will depend on whether the PBM can prove the FTC made false statements. But winning the lawsuit may not be what the PBM is looking for.

More than half (60%) of patients in latest trial reached active remission and 41% stopped taking corticosteroid entirely.

Express Scripts alleges in its suit that the FTC followed “prejudice and politics, not evidence or sound economics,” and that there is no support for the assertion that the power of PBMs has increased over time.

The new program, which begins in January 2025, provides members of Prime Therapeutics support for navigating utilization management requirements and finding financial assistance.

An Ohio State University survey found that many adults are hesitant about getting flu, COVID-19, pneumococcal and respiratory syncytial virus (RSV) vaccines.