PhRMA

MARCH 12, 2025

Specifically, HCPs raised concerns over how pharmacy benefit managers (PBMs) and insurers inappropriately use utilization management tools, like prior authorization, to deny or delay care, ultimately harming the patient and impacting patient access to care.

Patient Care 303

Patient Care Insurance 303

Drug Topics

FEBRUARY 15, 2024

Innovation in the vaccine area continues. In 2023, the FDA approved six vaccines, including several important firsts. But they face a difficult landscape where federal policies dictate coverage.

Vaccines 461

Vaccines Insurance FDA 461

PhRMA

MARCH 17, 2025

Half of every dollar spent on medicines goes to entities that don’t make medicine—like pharmacy benefit managers (PBMs) and insurers who are aggressively consolidating their control over health care and hospitals, clinics and for-profit pharmacies in the 340B markup program.

Insurance 268

Insurance Hospitals 268

PhRMA

OCTOBER 18, 2022

Insurers and pharmacy benefit managers (PBMs) continue to shift more and more costs to patients. For seniors who rely on Medicare Part D, the out-of-pocket costs for medicines can sometimes be a barrier. And a new analysis from the Medicare Payment Advisory Commission (MedPAC) shows why this is a problem that must be addressed.

Insurance 277

Insurance 277

PhRMA

DECEMBER 14, 2022

A survey of more than 5,000 Americans conducted with Ipsos found that insured Americans want better health care coverage.

Insurance 279

Insurance 279

PhRMA

DECEMBER 8, 2022

A survey of more than 5,000 Americans conducted with Ipsos found that 30% of insured Americans say they face a financial barrier to care, such as unaffordable out-of-pocket costs or a lack of savings to pay for emergency or unforeseen expenses.

Insurance 263

Insurance 263

Drug Topics

JULY 27, 2023

The National Rosacea Society found that a lack of health insurance or the high cost of a copay caused 52% of respondents to avoid obtaining medical care for their rosacea.

Insurance 247

Insurance 247

STAT

DECEMBER 11, 2024

A proposed Senate bill that would prohibit companies that control health insurers or pharmacy benefit managers from owning pharmacies rattled investors on Wednesday, but some Wall Street analysts believe the legislation is unlikely to gain much traction, at least for now.

Insurance 130

Insurance Independent Pharmacies 130

Drug Topics

DECEMBER 19, 2023

Social determinants of health (SDOH), such as financial disparities or lack of insurance, create barriers to accessing breakthrough therapies like BTK inhibitors among patients with CLL and SLL.

Insurance 551

Insurance 551

Drug Topics

MARCH 20, 2023

The company also will establish a $35 out-of-pocket price cap for for all patients with commercial insurance that use Latnus

Insurance 468

Insurance 468

The Guardian - Pharmaceutical Industry

NOVEMBER 5, 2024

Pharmaceutical’s weight loss pill described as ‘underwhelming’, also piling pressure on share price AstraZeneca shares tumbled on Tuesday wiping £14bn off the value of Britain’s biggest drug maker, after a report that dozens of senior executives at its China unit could be implicated in an insurance fraud case in the country’s pharmaceutical sector.

Insurance 107

Insurance 107

Drug Topics

AUGUST 21, 2023

A recent study found that Infants younger than 3 months, those born prematurely, and those who were publicly insured were at a higher risk for intubation.

Insurance 459

Insurance 459

Drug Topics

APRIL 9, 2024

Brian Rakers, senior vice president of distribution and member support at Pharmacists Mutual Insurance Group, talked cybersecurity during a session at AAP 2024.

Independent Pharmacies 407

Independent Pharmacies Insurance 407

Drug Topics

MAY 25, 2023

Iowa's Department of Health and Human Services, which manages the two health insurers that delivered care to adults and children in the state’s Medicaid program last year, was alleged to provide inadequate mental and behavioral health care to children on Medicaid.

Insurance 468

Insurance 468

Drug Topics

APRIL 27, 2023

The average annual healthcare spending for people with employer-sponsored insurance spending increased from $5,630 in 2020 to $6,467 in 2021. After decreasing in 2020, per person healthcare spending increased 15%.

Insurance 452

Insurance 452

Drug Topics

MAY 8, 2023

A new CDC report on data collected by the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy, indicates that medication for opioid use disorder is more often given to individuals who are White, older, and have private insurance.

Insurance 469

Insurance 469

STAT

JULY 25, 2024

Insurers like UnitedHealth are profiting off of the Medicare Advantage system, and it’s causing problems for both doctors and patients. Traditional Medicare is run by the federal government, while Medicare Advantage health insurance plans are operated by private companies like UnitedHealth. Read the rest…

Insurance 143

Insurance Hospitals 143

PhRMA

NOVEMBER 16, 2022

There is only one place in the health care system where middlemen refuse to share negotiated prices with patients, and that’s at the pharmacy counter. A new report reveals how this harmful tactic leads to higher costs for patients.

Insurance 299

Insurance 299

Drug Topics

APRIL 16, 2024

Findings indicating that socioeconomic disparities widened gaps in vaccination timeliness signal the need for increased efforts to promote timely vaccination among children from families with lower income and those without private insurance.

Vaccines 386

Vaccines Insurance 386

PhRMA

MARCH 2, 2023

Health plans are increasingly using deductibles and coinsurance to shift more of the cost of care to chronically ill patients taking brand medicines.

Insurance 320

Insurance 320

The Checkup by Singlecare

DECEMBER 2, 2024

Plus, we’ve got tips on how to save, even if you don’t have insurance. How much does Combivent Respimat cost without insurance? For people who don’t have insurance or Medicare—or whose plans don’t cover Combivent Respimat—the average retail price is $636 for a 4 gm of 20–100 mcg/act inhaler with 120 inhalations. Many times, yes.

Insurance 52

Insurance Insurance Coverage Dosage FDA 52

STAT

DECEMBER 11, 2024

would force the companies that own health insurers or PBMs to divest their pharmacy businesses within three years. Federal Trade Commission , The Wall Street Journal reports. A Senate bill, sponsored by Sens. Elizabeth  Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.),

Insurance 112

Insurance 112

STAT

SEPTEMBER 9, 2024

The Biden administration on Monday announced it would finalize a highly anticipated proposal meant to force health insurers to cover mental health care on the same basis as physical health conditions. 

Insurance 145

Insurance 145

STAT

DECEMBER 12, 2024

Like many Americans, Holden Karau said she was fed up with health insurance. The software engineer’s disillusionment began in 2019, when her insurer, UnitedHealthcare, balked at covering physical therapy after she was hit by a car and could not walk.

Insurance 145

Insurance 145

The Checkup by Singlecare

MARCH 11, 2025

Without insurance, Zonisamide costs about $92 for 60, 100 mg capsules. Without insurance, the average retail price of the Zonegran brand is higher than that of the generic. Is zonisamide covered by insurance? Most insurance plans cover zonisamide , but the copay amount will vary by plan.

Insurance 52

Insurance Insurance Coverage FDA 52

The Checkup by Singlecare

DECEMBER 30, 2024

Without insurance, the average retail price for two FreeStyle Libre 3 Plus sensors, a 28-day supply, is $232. The price without insurance adds up to just over $3,000 for one year. Is FreeStyle Libre 3 covered by insurance? Insurance plans are different and may or may not cover the FreeStyle Libre 3 Plus sensor.

Insurance 52

Insurance Insurance Coverage FDA 52

Drug Topics

SEPTEMBER 11, 2024

To further understand PBM market concentration, researchers separately analyzed commercial insurance, Medicare Part D, and Medicaid managed care market strategies of the 3 biggest PBMs.

Insurance 346

Insurance 346

STAT

MAY 29, 2024

Health insurers are telling shareholders that they are ramping up the use of artificial intelligence and are hiring talent to implement the technology across their organizations. However, all five of the insurers STAT contacted declined to elaborate on how they are using AI. Continue to STAT+ to read the full story…

Insurance 145

Insurance 145

PhRMA

OCTOBER 5, 2022

Insurer-imposed barriers like high deductibles and coinsurance shift the cost of life-saving care onto patients. Manufacturers and others have stepped forward to assist patients who face high out-of-pocket costs, using programs like copay coupons to help eligible, commercially insured patients afford their out-of-pocket costs.

Insurance 312

Insurance 312

The Checkup by Singlecare

MARCH 25, 2025

Without insurance, the average retail price of lacosamide is $1,067 for 60, 100 mg tablets. How much does lacosamide cost without insurance? The cost of lacosamide may vary depending on the dosage, quantity, pharmacy you purchase from, insurance plan, and the plans drug formulary. Related: What is lacosamide?

Insurance 52

Insurance Mail-Order Pharmacies Insurance Coverage Independent Pharmacies 52

STAT

OCTOBER 4, 2024

Health insurance companies will still offer older adults a lot of plan choices with low, or completely free, premiums. However, insurers have made important but subtle tweaks to next year’s plans that will force millions of members to shell out more for their prescription drugs and overall medical care than they do currently.

Insurance 138

Insurance Health Insurance Companies 138

STAT

SEPTEMBER 13, 2024

For years, health insurers battled to gain market share in the lucrative privatized Medicare program. When insurers release their 2025 plan offerings on Oct. Now, the opposite is true. Some of the companies say they designed their 2025 plans with an eye toward ditching members.  1, there likely will be fewer choices and freebies. 

Insurance 137

Insurance 137

The Checkup by Singlecare

JANUARY 10, 2025

NP Thyroid costs about $59 without insurance for 30, 60 mg tablets. Is NP Thyroid covered by insurance? In fact, NP Thyroid has not been through the FDA approval process, which is likely why many health insurance plans exclude it or require additional steps for coverage. How much does NP Thyroid cost without insurance?

Insurance 52

Insurance Insurance Coverage Pharmaceutical Companies Pharmaceutical Companies 52

Drug Topics

FEBRUARY 17, 2025

The Institute for Clinical and Economic Review assessed the formularies of 11 payers, covering 57 million people, to determine access to drugs that the organization had reviewed for cost effectiveness in 2022.

Insurance 247

Insurance 247

PhRMA

FEBRUARY 16, 2023

Did you know that insurance companies use middlemen — known as pharmacy benefit managers (PBMs) — to decide what medicines people can get and what people pay out of pocket for those medicines?

Insurance 328

Insurance 328

STAT

OCTOBER 24, 2024

A federal watchdog found that Medicare Advantage insurers collected billions of dollars in dubious payments from Medicare in a single year by using home visits and medical chart reviews to diagnose patients with conditions for which they received no follow-up care.   

Insurance 145

Insurance Medical Records 145

STAT

APRIL 9, 2024

One of the country’s biggest life insurers is venturing into genetic testing, an area that’s historically been a minefield for that industry, in a purported effort to keep its members alive longer.    MassMutual announced Tuesday that it’s offering many of its 4.2 The Springfield, Mass.-based

Insurance 145

Insurance 145