Member Content

Guidelines Offer Little Clarity on Future of Vertical Deals

July 9, 2020

On June 30, the Trump administration released the first major update to regulators’ guidance on vertical mergers and acquisitions since 1984. The document from the Federal Trade Commission and Dept. of Justice (DOJ) has already drawn controversy, as two FTC officials issued dissenting statements arguing the guidelines aren’t critical enough of deals that consolidate multiple parts of a supply chain.

However, health care and legal experts aren’t convinced that the new guidelines will provide much more assistance to firms hoping to execute vertical transactions akin to insurer Cigna Corp. buying PBM Express Scripts, pharmacy giant CVS Health Corp. buying insurer Aetna, or UnitedHealth Group — which already owns an insurer and a PBM — purchasing a bevy of other care-delivery assets.

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DOJ, Drugmakers Renew Disputes Over Charitable Foundations

July 9, 2020

Two lawsuits — one against federal health regulators by a drugmaker and the other against a drugmaker by the Dept. of Justice — represent the latest salvos in the dispute over whether and how drug company-supported charities can help patients pay for expensive medications.

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IngenioRx Buys ZipDrug in Bid to Boost Adherence, Convenience

July 9, 2020

In what one expert calls a “logical” move for a PBM vying for business from cost-conscious payers, Anthem, Inc.’s IngenioRx said on July 6 that it acquired ZipDrug, a company that focuses on improving patients’ medication adherence and affordability.

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Scant Details, Comment Period for VBP Proposal Draw Concern

July 9, 2020

A new proposed rule (85 Fed. Reg. 37286, June 19, 2020), which CMS touted as a way to tweak Medicaid’s best-price provision to encourage more value-based purchasing (VBP) for expensive drugs, has drawn considerable criticism from stakeholders across the health care system. Experts say the rule is much more complex than it was initially made to seem, and the 30-day comment period is unusually short for such a substantial change.

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Medicaid Pays Millions in Excess Costs Due to Delayed Generic Drug Entry

July 9, 2020

by Jinghong Chen Among the 69 brand-name drugs that were expected to lose market exclusivity between 2010 and 2015, only 38 products saw the launch of generic versions either before or within one quarter of the expected date, according to a recent study published in Health Affairs. For the 31 drugs whose generic entry was […]

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News Briefs

July 9, 2020

✦ A new report from UnitedHealth Group-owned OptumRx puts a spotlight on prescription prenatal vitamins — which the PBM counts among an “influx of clinically superfluous brand drugs that carry hefty price tags but offer little to no added clinical value.” According to OptumRx, some of the “worst offenders” include Solubiomix’s Azesco, Foxland Pharmaceuticals’ Trinaz, 7T Pharma’s Genicin Vita-S and TMIG Inc.’s Lorid, which have an average cost of $5,600 for a 90-day supply vs. $44 for a generic alternative covered by the PBM. Read more at https://bit.ly/31TWn6p.

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