RX Alerts

Your Plan CAN Decrease Its Costs (but you need to act for it to do so)

We’re thrilled to report yet again that our National Prescription Coverage Coalition has achieved striking savings for our Coalition Members.

Based on year-end analyses, our Coalition Members decreased their prescription coverage costs by approximately 20% to 30%. 

Sound too good to be true?

It’s not. Read this article to learn how our Coalition Members achieved their savings, and to obtain specific facts about just how much they saved.

Act Now – Block Lyrica CR Preemptively

If your Plan wants to control its prescription coverage costs – and minimize disruption to your plan beneficiaries – your Plan needs to act preemptively to block certain drugs before they even enter the market. Lyrica CR exemplifies why.

Read this article to understand Pfizer’s – and other manufacturers’ – ploys that prevent your Plan from saving money from generic drugs. And learn how you can counter manufacturers’ strategies by blocking certain newly-approved, but entirely unnecessary, drugs before your Plan beneficiaries start taking them.

Plan Administrators: Limit Your Restasis Coverage

If you missed the latest example of drug manufacturer abuse, you need to learn about Allergan’s Restasis antics, understand your Plan’s resulting costs, and take action in response.

Why? Because you’ll not only save your Plan considerable money by acting on a single drug, you’ll also help teach Allergan a much-needed lesson and discourage other manufacturers from engaging in similar abuses.

Go here to read our full article.

Plan Administrators and Fiduciaries: It’s Time To Take REBATE ACTION – File An Accounting Procedure!

As newspaper articles multiply describing  PBMs’ questionable rebate conduct, every Plan administrator and fiduciary should consider filing a lawsuit against your PBM seeking an “accounting”.

As a Plan administrator or fiduciary, you’re charged with ensuring your Plan receives all monies your Plan is entitled to receive. Moreover, through an accounting, you’re likely to discover your PBM has been hiding large amounts of monies that, if reimbursed, would significantly decrease your Plan’s costs. And given the amounts your Plan may recover, you’ll likely be able to locate a law firm to file a lawsuit on a contingency basis, meaning the litigation won’t cost your Plan a dime.

Read this article to understand why you should file an accounting proceeding, and the information that you should seek.

Time To Determine If Your PBM Is Hiding Rebates

Express Scripts New Lawsuit Reveals There May Be Large Amounts of Hidden Monies

For years, PBMs have consistently refused to disclose any information about their secret “deals” with manufacturers to obtain “rebates” – that PBMs presumably pass through – and “other monies” – that PBMs collect from manufacturers but PBMs may retain for themselves.

But now, a new lawsuit filed by Express Scripts against the drug manufacturer kaleo reveals at least some information about Express Scripts secret deals. And the information is shocking.

Express Scripts is clearly collecting mega-millions of dollars from manufacturers, and much of that money is labeled “administrative fees” and “price protection rebates” that Express Scripts may not be entirely passing through to its clients or the federal government.

Every Plan administrator and fiduciary – and the federal government – should insist on learning more about the millions that Express Scripts and other PBMs are collecting. Go here to learn more.


Want To Decrease Your Rx Coverage Costs? Pay Attention to Horizon Pharma’s 1st Quarter Report

Horizon Pharma – the manufacturer of three extremely expensive drugs – Vimovo, Duexis and Pennsaid – just released its Quarterly Earnings Report causing its stock to plummet.

The Report should cause every Plan to stop providing coverage for all 3 of these drugs and stop relying on its PBM’s “standard” Formulary.

Read this article, and you’ll understand why.