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💊 340𝐁 𝐂𝐨𝐯𝐞𝐫𝐞𝐝 𝐄𝐧𝐭𝐢𝐭𝐢𝐞𝐬 𝐒𝐭𝐢𝐥𝐥 𝐍𝐨𝐭 𝐏𝐚𝐬𝐬𝐢𝐧𝐠 𝐃𝐢𝐬𝐜𝐨𝐮𝐧𝐭𝐬 𝐭𝐨 𝐍𝐞𝐞𝐝𝐲 𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬 Yikes! Only 3% to 5% of branded 340B prescriptions at retail and mail-order contract pharmacies were filled using a 340B drug discount card. That’s

Payer-operated practices are gaining in U.S. primary care. Vertically integrated insurers now account for 4.2% of total primary care in 2023, up from 0.8% in 2016. 👇In 3 large counties, Optum alone controls 35%–45% of primary care. 👉 drugch.nl/4eDPs4s

A troubling trend: Large insurers are denying a greater share of prescription drug claims. The usual suspects: Cigna Healthcare , Aetna , UnitedHealthcare , Elevance Health , Humana Caveats: Limited visibility into methodology or the reasons for denial. Source: Komodo Health The New York Times

𝐓𝐡𝐞 𝐂𝐨𝐥𝐥𝐚𝐩𝐬𝐞 𝐨𝐟 𝐒𝐭𝐚𝐧𝐝-𝐀𝐥𝐨𝐧𝐞 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐏𝐚𝐫𝐭 𝐃 𝐏𝐥𝐚𝐧𝐬: 𝐖𝐡𝐚𝐭 𝐂𝐨𝐦𝐞𝐬 𝐍𝐞𝐱𝐭? Ever since the IRA was passed, we've been pointing out the ever-growing unintended consequences of this hastily-passed law. One of the most significant

𝐇𝐨𝐰 𝐅𝐨𝐫𝐦𝐮𝐥𝐚𝐫𝐲 𝐁𝐚𝐫𝐫𝐢𝐞𝐫𝐬 𝐃𝐞𝐫𝐚𝐢𝐥 𝐂𝐚𝐫𝐞 𝐟𝐨𝐫 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐏𝐚𝐫𝐭 𝐃 𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬 New data from IQVIA paints a troubling picture: ➡️ After one year, 18% to 42% of new Medicare Part D patients still hadn’t gained approval for their originally

From Informa Connect: Informa Connect’s Medicaid Drug Rebate Program Summit September 15-17, 2025 | Chicago, IL *** Promo code for discount: 25DRCH10 *** Details ==> drugch.nl/4lHTA5O #sponsored

New J&J Innovative Medicine $JNJ report offers unprecedented transparency into #drug pricing & #GrossToNetBubble: - $47.8 B in rebates, discounts & fees for 2024 (+11.7% vs. 2023) - $14.7 B to comm'l payers & #PBMs (+9.7%) - $7.4 B to #340B providers (+23.3% !) ==> drugch.nl/4kRJVZJ

𝐄𝐦𝐩𝐥𝐨𝐲𝐞𝐫𝐬 𝐀𝐫𝐞 𝐑𝐞𝐭𝐡𝐢𝐧𝐤𝐢𝐧𝐠 𝐏𝐁𝐌 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬—𝐁𝐮𝐭 𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐖𝐨𝐧'𝐭 𝐒𝐡𝐚𝐫𝐞 𝐢𝐧 𝐃𝐢𝐬𝐜𝐨𝐮𝐧𝐭𝐬 77% of employers consider managing the cost of GLP-1 medications “extremely/very important”—making it the top pharmacy benefit

🚨 𝐏𝐁𝐌 𝐄𝐱𝐜𝐥𝐮𝐬𝐢𝐨𝐧𝐬 𝐇𝐢𝐭 𝐑𝐞𝐜𝐨𝐫𝐝 𝐇𝐢𝐠𝐡𝐬 𝐢𝐧 2025 The three largest PBMs are excluding more medications than ever before: 🔹 842 single-source brand-name drugs (with no generic or biosimilar alternatives) 🔹 611 unique generics 🔹 37 unique biosimilars

From CareMetx Team: 𝐁𝐞𝐲𝐨𝐧𝐝 𝐓𝐡𝐫𝐨𝐮𝐠𝐡𝐩𝐮𝐭: 𝐁𝐮𝐢𝐥𝐝𝐢𝐧𝐠 𝐑𝐞𝐯𝐞𝐫𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬 𝐓𝐡𝐚𝐭 𝐒𝐚𝐟𝐞𝐠𝐮𝐚𝐫𝐝 𝐀𝐜𝐜𝐞𝐬𝐬 Download: "Rethinking Annual Reverification: A Strategic, Multi-Layered Approach to Protecting Patient Access":

If you think UnitedHealth Group $UNH has become a bloated, unmanageable company that's more interested in profit mining than patient care, then you'll enjoy this takedown from The American Prospect. 👉 drugch.nl/3ILnOHa

Medicare Part D spending on dermatology prescriptions: Innovation > Price Hikes • Specialty meds = 3% of Rx / 81% of gross (pre-rebate) spending • Spending growth due to new therapies, not rising prices • Market share diversifying 👇 JAMA Dermatology drugch.nl/3U7GLWZ

🚨 Check the sky — pigs might be flying! 🚨 I find myself agreeing (at least in part) with Benjamin Rome Ben Rome and colleagues in their recent JAMA editorial: “Although the US spends more per capita than peer countries on prescription drugs, it does not necessarily spend more

☀️ 𝐍𝐞𝐰 𝐨𝐧 𝐃𝐫𝐮𝐠 𝐂𝐡𝐚𝐧𝐧𝐞𝐥𝐬: 𝐉𝐮𝐥𝐲 2025 𝐍𝐞𝐰𝐬 𝐑𝐨𝐮𝐧𝐝𝐮𝐩 Let’s cut through the steamy summer haze with a refreshing breeze of healthcare insights—perfect poolside reading. 🩺 340B Discounts Still Not Reaching Needy Patients 💊 Why do patients switch from