Politicians who defend the pharmacy-benefit-management model are siding with fewer drug choices, lower-quality products, and higher patient costs.

Alternative pharmacy benefit manager Serve You Rx is seeking to generate additional savings for its clients by adding two biosimilars for the popular drug Stelara to its formulary. The PBM will ...

In addition, employer groups may benefit from outsourcing their utilization management away from the PBM and to an independent entity, maintaining clear criteria for formulary construction and ...

The trade group representing pharmacy benefit managers disagrees. The Pharmaceutical Care Management Association, also known as PCMA, did not return requests for comment on this story.

DES MOINES, Iowa — As the end of the 2025 legislative session is near, the PBM reform bill is still waiting for its fate. Pharmacists across the state have championed a bill that would reform ...

New proposed legislation would make it illegal for a company to own both a pharmacy and a pharmacy-benefit management company. Pharmacy benefit managers, or PBMs, negotiate drug prices for ...

But just as her health improved, the family learned that MedImpact, the pharmacy benefit manager for her insurer, denied coverage for Rinvoq.

Lark Health unveils LarkVantage, an AI-powered tool to manage GLP-1 costs By Paige Minemyer Jun 17, 2025 6:00am Lark Health Blue Shield of California pharmacy benefit management Artificial ...

Pharmacy benefit manager reform could move us closer to health equity PBMs have distorted the system to enrich themselves, jacking up drug prices while delivering few tangible benefits to patients.

CVS pharmacy benefit manager Caremark must pay New York Cancer & Blood Specialists $17 million over a Medicare reimbursement formula that penalized the provider for limiting patients’ use of ...

And pharmacy benefit managers could not impose higher fees or change a patient's cost sharing based on which pharmacy they go to. Any amount paid by a patient for a prescription drug would be ...

Brandon, who spoke at PBMI (Pharmacy Benefit Management Institute), pointed to the underlying factors contributing to drugstore closures. They include operating costs that have increased greatly ...