PBM transparency legislation was passed via the PBM Reform Act (Rep Buddy Carter).
FTC settled with 2/3 of the big three PBMs. There are 30 days for public comment. We are still waiting for a UHG settlement.
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Thank you for all your work on this!
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@mohe0001 While it sounds encouraging and I appreciate the effort to keep us informed, so many other promises of reform and accountability have failed that the “proof is in the pudding!” I’ll wait to see what actually gets put in to effect, what gets pretended to satisfy government regulators, how earnest PBMs are to comply, versus what actually helps people afford their needs. Sorry if that sounds skeptical, but it’s been earned all too well by corporations, PBMs, and government regulators including the FTC. Lest I be considered to questioning, my wife worked at FTC for career, she is and should proud of herself and her achievements, not so much the Commission; the FTC fills its coffers with awards and none of it goes back to the people corporations that profited, and few of FTC’s actions, particularly the big ones, make life better for the people because they settle to easily. Perhaps this will be the case that proves that wrong! Hope springs eternal!
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No one has been burned more than we have. This took 18 years. I understand. These are the first real legitimate pieces of antitrust legislation & regulation in my lifetime. This is an honest effort in that they gave us most everything we asked for.
Here’s the details on cigna:
One primary outcome is that it strengthens state cases (of which there are a growing number). Minnesota is the only state, to date, to settle with the insulin manufacturers (but not the PBMS). California will settle next, followed by Oregon, Missouri, and Delaware, etc. CA sued BOTH the insulin manufacturers AND the PBMs simultaneously (that’s bold, but they are a large state w/ a lot of resources). Oregon wants $900 million. Attorney General Dan Rayfield Files Lawsuit Seeking $900 Million to Hold Drug Companies and Middlemen Accountable for Skyrocketing Insulin Prices - Oregon Department of Justice : Media
Now we enter that phase where we want damages paid, but we don’t want to bankrupt the companies. We don’t want to cause the whole system to collapse, we just want to inject integrity. The system needs to stabilize before we do anything else. The goal is not to tip over the whole thing like a house of cards. That’s tricky. You saw how UHGs stock price price plummeted when everybody (including it’s own stockholders) started attacking it simultaneously. Everyone was so filled with wonton bloodlust, seeking revenge against the insurers. We have to be careful now.
People are starting to respond to it online: FTC and Express Scripts settle lawsuit over insulin pricing | STAT
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Absolutely correct, sir!
The PBMs aren’t going to take this lying down. There’s no doubt that they have adjusted their plans to find other ways to skin the cat.
I’m mobilizing some doctors for a subsequent attack. Optum's provider acquisitions tied to price increases for rival insurers: Study - Becker's Payer Issues | Payer News The cat will fight back!
Here’s the diabetics discussing PBM reform: #1224 Orange Book Chronicles — JUICEBOXPODCAST.com
Amazing work @mohe0001 ! Proud of you!
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I thought of you the other day when I saw this, Brad, @bpollina . Heads up! https://healthexec.com/topics/healthcare-management/legal-news/missouri-becomes-latest-plaintiff-lawsuits-against-pbms-drug-companies-over-skyrocketing-insulin
Still no settlement with UHG. Troubling.
They will hold a hearing for a PBM bill at the State capitol in Wisconsin on Feb 11th.
The pharmacists are at it again. https://www.youtube.com/watch?v=oil1ifvg6z8
The doctors are enraged, but disorganized. Here’s one of the lobbyists for independent physicians speaking with a policy expert from John Hopkins. They discuss the role of digital advocacy. https://x.com/DutchRojas/status/1993801944549224852?s=20