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Monday, Jul 22 2024

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Audit Finds One Of The Largest PBMs Overcharged Postal Workers Millions

Express Scripts charged USPS employees an extra $45 million for prescription drugs over a five-year window, a federal audit found. Meanwhile, pharmacy trade groups are lobbying for legislation to regulate PBMs, pointing to the closure of community pharmacies across the U.S.

Express Scripts, one of the largest pharmacy benefit managers in the country, overcharged U.S. Postal Service employees by a whopping $45 million for their prescription drugs during a recent five-year period, according to a federal audit. (Herman and Silverman, 7/22)

Pharmacy trade groups are pushing for state legislation to regulate pharmacy benefit managers, arguing that PBMs are forcing community pharmacies to close across the US, including regions with few health-care options. In 2024 state legislative sessions, lawmakers introduced more than 170 bills in 41 states seeking to regulate the entities that manage prescription drug benefits, according to the National Academy for State Health Policy. The top three PBMs鈥擟VS Caremark, Cigna鈥檚 Express Scripts, and UnitedHealth Group鈥檚 OptumRx鈥攃ontrol nearly 80% of the market. (Castronuovo, 7/22)

When Jacqueline Vakil needed a refill for Flovent, her 4-year-old son鈥檚 asthma medicine, she couldn鈥檛 get it. The drugmaker GSK had stopped making the popular inhaler, back in January. To make matters worse, Vakil鈥檚 insurance provider wouldn鈥檛 cover the alternative drug their doctor suggested. 鈥淚t got to the point that I was on the phone constantly with our doctor to try to find a substitute,鈥 Vakil says. (Yu, 7/22)

Hims & Hers Health Inc. is cooperating with an inquiry from the US Federal Trade Commission for more information. 鈥淲e support the FTC鈥檚 mission to protect customers and we strive to ensure best practices in everything that we do,鈥 a spokesperson said in an email to Bloomberg. 鈥淲e are voluntarily cooperating in responding to an FTC inquiry for information.鈥 (Muller, 7/19)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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