For a period of time, federal and state agencies made concerted efforts to control the cost of prescription drug spending, agreeing to use a reimbursement methodology that best reflects actual drug costs. Many states, however, used different methodologies to calculate drug cost. According to the U.S. Health and Human Services (HHS), such fluctuations in methodologies

         A survey conducted by the National Community Pharmacists Association (NCPA) revealed that almost all independent pharmacies experience significant increase in drug acquisition cost while reimbursements are not simultaneously adjusted to reflect the increase. Often, reimbursements are adjusted but with remarkable delays. When pharmacies appeal these MAC reimbursements and delays in adjusting generic pricing, the appeals

   In 2018, CMS proposed a Medicare rule that would eliminate retroactive DIR fees. One of the rationales for the rule was a colossal growth of DIRs between 2010 and 2017. During this period of time, DIRs grew by 45,000%.

As a result of this aggressive “performance enforcement” by PBMs, many pharmacies are reimbursed below cost

More and more states are mandating e-prescribing. Some states require e-prescribing only for CII controlled substances, some for all controlled substances, and some require e-scripts for all medications.

States with current e-Rx mandate laws are:

    • Connecticut (e-prescribing for controlled substances only, no penalties for non-compliance)
    • Maine (e-prescribing for controlled substances only, penalties provided)
    • Minnesota (all

A new healthcare giant is here! CVS has closed a 69-billion merger with Aetna, the nation’s third-largest health insurer. The companies have recently announced that all necessary approvals had been obtained (New York was the last state to sign off on the deal).

Several states opposed the merger due to potential antitrust issues (federal regulatory

In attempt to counterbalance Amazon, Walmart has recently signed a deal with Anthem to provide Medicare enrollees with over-the-counter medications and health supplies at its stores.

For quite some time, Walmart has been making advances in the healthcare sector. For example, it already provides eye care at roughly 3,000 in-store vision centers and free health

Walgreens has entered into agreement with DaVita to purchase its non-dialysis related prescription files, mostly under Medicare Part D. Currently, DaVita uses a drug distribution facility in Orlando for dispensing by mail non-dialysis medications. The deal with Walgreens is scheduled to finalize in late September, at which time the files of the facility will be

I have been closely watching Amazon’s attempts to enter pharmaceutical market,[1] but even for me, Amazon’s acquisition of PillPack came as a surprise.

For those not familiar with PillPack (which has its headquarters on the East Coast), it specializes in single-dose medication packing, deliveries, and prescription management targeting chronic-disease patients. It acts as an online