News

Pharmacy benefit managers are moving beyond formulary access to provide support programs for women's health. Here's how three PBMs — Judi Health, LucyRx and RxPreferred — are putting that strategy into practice.

Women face more gaps in healthcare than men, from missed screenings, undertreatment and biased coverage. PBMs are launching programs to address some of the gaps.

ProAct Chief Operating Offier Deborah Dempsey says plan sponsors still lack the data and visibility to know whether they were shorted on a 340B claim.

AACR Cancer Progress Report 2026 highlights a 35% U.S. cancer death decline, new FDA advances, persistent disparities, and urgent calls for stronger NIH/NCI funding.

OrionRx's Don Anderson, Pharm.D., says a GLP-1 access model built around mandatory wellness coaching resulted in a six-point drop in body mass index and improved mental health.

Yellow eyelid Xanthelasma signals hidden high cholesterol and cardiovascular disease risk, tripling heart attack and stroke odds; Negin Yavari, M.D., and her team urge screening.

Maladaptive coping at baseline raised relapse and symptom risk over 12 months in first episode psychosis, King's College London researchers found.

Navitus launched three modular options that let plan sponsors manage diabetes, weight, and lifestyle therapy access, cost, and outcomes with guaranteed ROI.

ProAct's Deborah Dempsey, Pharm.D., MBA, RPh, explains how 340B discounts to healthcare entities are in conflict with rebates that manufacturers pay to health plan sponsors.

Rybrevant (amivantamab) plus chemotherapy reached a 34.3-month median survival in EGFR exon 20 insertion-positive lung cancer, Johnson & Johnson said.

Optum Rx's PreCheck Prior Authorization tool automates 64% of approvals in under 30 seconds, getting patients onto therapy four days faster, Anne Mall, MHA, says.

OrionRx's Don Anderson, Pharm.D., outlines near-term and long-term fixes for the blind spots created when members buy medications outside their pharmacy benefit.

StarkRx has launched as a modular, cost-plus pharmacy benefit management company for self-funded employers using Judi Health’s PBM, Judi Rx, to administer claims.

OrionRx's Don Anderson, Pharm.D., says drugs filled outside a member’s pharmacy benefit could result in excessive and duplicative prescriptions.

As PBMs plan for 2028 rollout of the PBM transparency provisions of the Consolidated Appropriations Act of 2026 (CAA 2026) cost-plus pricing will flip how drug costs look on paper, requiring far more data, says Milliman principal Kessler.

GLP-1 therapies now drive nearly half of prescription drug sales growth, IQVIA's Scott Biggs told PBMI 2026 attendees, reshaping diabetes treatment and pharmacy dispensing economics nationwide.

Kessler, a principal at Milliman, says employers need to pay attention to their claims and pharmacy benefit contracts.

Northwell Health reports rising 9/11-linked cancer rates tied to Ground Zero debris, as oncology teams expand screening and treatment for survivors and responders.

As concerns about GLP-1 costs grow, employers could be overlooking an even more pervasive condition driving healthcare spending.

A new randomized trial of criminal legal-involved people who use drugs found that 35.1% expressed interest in HIV pre-exposure prophylaxis, and of those, 60.8% preferred long-acting injectable formulations over daily oral PrEP.

The president of Vivid Clear Rx says PBMs should limit point solutions early on and warned against farming out too many services to vendors that a PBM should provide itself.

Yes, breaking up is hard to do, acknowledged the president of Vivid Clear Rx. But employers should be "brave" about severing their ties to one of the “big three” pharmacy benefit managers (PBMs) and contracting with mid-size PBMs like hers, says Amy Wadstrom, RPh.

A principal and product owner at Milliman, Kessler discusses some of the reasons for heightened attention and scrutiny of plan sponsor fiduciary responsibility when it comes to pharmacy benefits.

The president of Vivid Clear Rx says finding a GPO partner whose goals align with a PBM's moves transparency forward for clients.

Federal and state laws now require PBMs to report drug pricing, rebates, and prior authorization data, creating compliance challenges, said panelists PBMI's annual meeting in Orlando.

Preschoolers who are constantly "on the go" or interrupt others are up to six times more likely to receive an ADHD diagnosis, new national data show.

Prime Therapeutics taps Manmohan Mahajan as CFO, aiming to curb rising drug costs and expand affordability programs for health plans.

PBM, employer and pharmacy leaders at the Pharmacy Benefit Management Institute annual meeting said actionable data and real-time technology, not just transparency, are needed to control rising costs.