Remove Documentation Remove Drug Pricing Remove Specialty Pharmacies
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STAT+: Tennessee officials find Express Scripts violated law governing commercial pharmacy claims

STAT

In an unusual move, an audit of commercial health plans by Tennessee officials found that Express Scripts, one of the largest pharmacy benefit managers in the United States, violated state laws in its dealings with pharmacies, according to newly released documents.

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Independents Outshine PBMs in Manufacturers’ Exclusive Specialty Pharmacy Networks (rerun)

Drug Channels

This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: The 340B Drug Pricing Program: Trends, Controversies, and Outlook. Last week, we documented the substantial concentration of dispensing revenues for specialty drugs. Click here to see the original post from April 2024.

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PBM-Owned Specialty Pharmacies Expand Their Role In—and Profits From—the 340B Program

Drug Channels

Last week, I documented that nearly half of U.S. pharmacies now participate in the 340B Drug Pricing Program. Below, we update our exclusive analysis of the biggest specialty pharmacies within 340B. Hospitals are the primary 340B covered entities that engage with these specialty pharmacies.

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Navigating 340B Program Changes in 2025

Proxsys Rx

Regardless of your answer, theres no question the 340B Drug Pricing Program remains a critical resource for eligible healthcare providers, enabling them to stretch scarce federal resources to provide essential services to underserved communities. Perform self-audits to proactively identify and address your 340B program gaps.

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NOW AVAILABLE: The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

Drug Channels

Pharmacies and Pharmacy Benefit Managers , our 13th edition, provides a comprehensive, fact-based, and non-partisan tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. The 2022 Economic Report on U.S. The chart below illustrates the depth and breadth of the 2022 edition.

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NHC Comments on Medicare Drug Price Negotiation Program: Draft Guidance, Implementation of Sections 1191 – 1198 of the Social Security Act for Initial Price Applicability Year 2027 and Manufacturer Effectuation of the Maximum Fair Price (MFP) in 2026 and 2027

Putting Patients First Blog

General Comments The NHC appreciates CMS’ commitment to actively engaging with stakeholders, including patients, consumer advocates, and health experts, in implementing the Medicare Drug Price Negotiation Program (DPNP). This includes collecting data on utilization management practices, formulary changes, and patient experiences.

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340B Outlook For 2024: Change. Change. And More Change.

Proxsys Rx

HRSA issues “Administrative Dispute Resolution” ruling On April 19, HRSA issued a ruling entitled “340B Drug Pricing Program; Administrative Dispute Resolution.” Understand, and master, your 340B specialty pharmacy opportunities. The 340B revenue potential of specialty pharmacy is staggering.