More impactful benefit changes coming in 2025; will destabilization among standalone plans follow?

As they revise and interpret merger guidelines, the Federal Trade Commission and Department of Justice should pay particular attention to the anticompetitive impact of consolidation in the pharmacy benefit manager market, the generic trade group suggests.

After motion to advance fails at 17 February meeting, proposed study design will be revamped, not scrapped. Despite the 2-2 deadlock on the vote, commissioners uniformly expressed an interest in proceeding with research on PBM industry, focusing on the leading players.

Oncology drugs are no longer immune to pharmacy benefit management formulary exclusions in the commercial market and even drugs administered in a physician’s office are increasingly being subjected to rebate-driven coverage decisions.