Pharmacy Group Alleges Price Fixing
A community pharmacy group has filed suit against Prime Therapeutics, alleging that the company colluded with fellow pharmacy benefits manager (PBM) Express Scripts to fix prices and engage in anti-competitive behavior. The suit alleges Prime accessed Express Scripts’ network to slash prices.
Additional article:https://www.modernhealthcare.com/insurance/mh-prime-therapeutics-lawsuit-express-scripts-pbm/
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#pbms #drugpricing #antitrust #pharmacies
Private Equity Deep In Hospitals
Private equity firms are expanding their healthcare reach through joint ventures with nonprofit health systems. A new report finds that more than 500 healthcare facilities operated through these nonprofit joint ventures.
#privateequity #hospitals
https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/122077
Tampa General Sues Eli Lilly On 340B
Tampa General Hospital is suing Eli Lilly over its cut off of 340B discounts, saying that violates Florida’s Deceptive and Unfair Trade Practices Act. The hospital alleges the discount change forced the price of Mounjaro from $750.52 per unit to $1,019.74 at wholesale acquisition cost, a 35.9% increase. Tampa alleges other violations as well.
#340b #hospitals #branddrugmakers
BCBSLA Loses Stars Lawsuit
Blue Cross and Blue Shield of Louisiana (BCBSLA) lost its most recent bid challenging how CMS calculated its 2025 Medicare Advantage (MA) Star rating. The court upheld a July 2025 district court ruling that found CMS acted within its authority when it gave a 3.5-Star rating to BCBSLA after it consolidated two contracts in 2024.
#medicareadvantage #cms #stars #quality
https://www.beckerspayer.com/legal/bcbs-louisiana-loses-2025-medicare-advantage-star-ratings-appeal/
GLP-1 Use On The Rise
A new Gallup survey finds a record number of Americans are taking GLP-1 drugs for weight loss. According to the poll, 11% of Americans currently take a GLP-1 medication for weight loss, compared to just 3% in 2024.
In other news, an employee benefit survey finds the share of employers covering GLP-1s for both diabetes and weight loss has held steady at 36% year over year.
Additional article: https://www.beckershospitalreview.com/glp-1s/employer-coverage-of-glp-1s-for-diabetes-weight-loss-remains-steady-at-36-survey/
#glp1 #weightlossdrugs
https://thehill.com/policy/healthcare/5957430-glp-1-drugs-weight-loss-rise/
— Marc S. Ryan
