Posts Tagged ‘PBMs’

Why Are People Quick to Quit GLP-1 Medicines? Is It Surprising?

July 12, 2024 — Reuters has a news flash for us. People are quick to quit taking GLP-1 medicines. In an “exclusive” story, the Reuters report comes from a analysis from Prime Therapeutics and Magellan Rx (Prime/MRx) – a pharmacy benefit manager (PBM). The headline finding is that 85% of people who start on GLP-1 medicines have quit taking […]

What Will Be Hot or Not in 2024 for Obesity and Health

January 2, 2024 — The year we just finished saw quite a pivot in the science and policy we cover here. So what will we pivot toward in 2024? What will leave us cold? Here are our best educated guesses for what will be hot or not in 2024 for obesity and health. #1 Hot: Pricing Drug prices will […]

The Best and Worst of 2023 in Obesity and Health

December 28, 2023 — This was a year of great progress in obesity, and with that progress came frustrations and angst. So finding the best and worst of 2023 in obesity and health is actually quite an easy and interesting task. Let’s dig right in. #1 Best: Cardiovascular Outcomes Benefit Data for Semaglutide Above all else the landmark findings […]

Is Drug Pricing Policy Really Poised for Change?

December 10, 2023 — Something’s gotta give. In health policy, angst about drug pricing is a constant. Businesses that spend billions to discover and develop new drugs need prices that will be sufficient to pay back the costs incurred for the drugs that succeed, plus the costs of many more that fail. But those prices drive ever higher costs […]

Who Benefits from Pharmacy Benefit Managers?

November 15, 2023 — A trip into the world of pharmacy benefit managers (PBMs) is enough to make our heads spin. It leads us to wonder: exactly who benefits from pharmacy benefit managers? The answer is not clear, but it seems obvious that patients in need of affordable medicine do not. In Search of a Fair Deal The biggest […]

Do PBMs Drive Drug Costs Up or Down? Can They Do Better?

November 6, 2023 — It is frustrating. The list price of Mounjaro (tirzepatide) is more than a thousand dollars per month. Pharmacy Benefit Managers (PBMs) negotiate costs for this drug that brings the average cost down to an estimated $215,  but many folks get stuck paying the full list price, forgoing treatment, or paying a copay that might exceed […]

The GLP-1 Windfall for Pharmacy Benefit Managers

October 24, 2023 — We have grown tired of the mindless repetition of a $1,350 monthly list price for Wegovy in endless news reports about the great expense of this very important new drug for obesity. Not because the drug isn’t expensive. But because that list price is not an accurate representation of what the drug really costs. So […]

Adherence to Medicine for Blood Pressure, Infection, and Obesity

July 17, 2023 — A recent thread in the ongoing public discourse about new, advanced obesity medicines relates to how long people should take them and how long they actually do take them. The revelation that started this is data from a pharmacy benefit manager (PBM) indicating that two-thirds of patients typically stop taking them within a year. So […]

Drug Prices? Not My Fault, Say PBMs and Pharma

May 12, 2023 — Don’t look at me! That’s basically how it went at a U.S. Senate hearing Wednesday. Top executives from PBMs (pharmacy benefit managers) and the three pharma companies selling insulin testified to suggest they’re doing everything they possibly can to keep drug prices low. PBMs point the finger at pharma. Pharma executives return the favor. Lilly […]

Is Health or Greed Driving Health Systems?

January 15, 2023 — Workers at the largest health system in the U.S., HCA, this week accused the system of putting profits ahead of patient care and health. We regularly hear from obesity care providers about insurers using lame excuses to deny coverage for obesity meds or surgery for lame reasons. This happens even when the health plan covers […]