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May 3, 2017

Headlines in the News

Aetna blows past estimates despite pressure in its Obamacare business
Business Insider, May 2, 2017

$94,000 drug costs only $200 to make, Blue Cross and Blue Shield says
WSOC TV, May 1, 2017

Anthem Not Ruling Out Long-Shot SCOTUS Review Of Cigna Deal
Forbes, May 1, 2017


Today's AIS Health Datapoint

$42 ... is the average 30-day retail copay for preferred brand drugs, in network, for gold-tier HMO plans on 2017 individual marketplaces. The average Rx deductible for these plans is $379.08, although only 11% use this cost-sharing method. Roughly 14% of plans require an overall deductible to be paid before cost-sharing begins.

From AIS’s Rx BENEFIT DATA

  Check out a demo of AIS Health's Rx benefit database

Quote of the Day

“This case does not shed light on the manifold legal and compliance complexities that surround PBM operations and contracting. Rather, it involves the payment of bribes that were siphoned off of administrative fees that were purposefully inflated by the parties to the scheme. These are not business activities that skirt close to the line — instead, they are brazenly criminal in nature.”

— John Linehan, an attorney in the health and sciences practice for Epstein Becker Green, tells Drug Benefit News that a recent kickback case involving a PBM CEO is not typical of industry executives.

Click here to read the DRUG BENEFIT NEWS article in which this quote appeared — "PBM Executive Pleads Guilty in $3.5 Million Kickback Scheme" (Free for DBN subscribers; $17 for non-subscribers.)

 

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