News and notes from around the interweb:PBMs ranked by market share: CVS Caremark is No. 1. Three companies dominate the pharmacy benefit manager market, accounting for 79 percent of all prescription claims in 2020, according to data from Health Industries Research Companies, an independent, non-partisan market research firm. To assess market share, HIRC used self-reported data from twenty-nine pharmacy benefit manager leaders collected in December 2020 and January 2021.Documenting Patient Interventions Is Essential. The most common MRPs or medication-related problems included Beers criteria medications (mostly antidepressants, protein pump inhibitors, gabapentin, and opioids), medication omission, drug-condition interaction, duplicate therapy, medication nonadherence, drug-drug interactions, untreated conditions, dose that were too low, and doses that were too high. MRPs were also equally prevalent among face-to-face versus phone interventions. However, the presence of documentation in the “assessment” section of the comprehensive medication review (CMR) was higher when MTM was conducted via phone (42%) compared to face-to-face (28%).Join the Movement!A shared opportunity: The future of cell and gene therapy. Despite the many challenges of the last two years, the global cell and gene therapy (CGT) market continues to rapidly expand. The investment landscape for regenerative medicine has grown 16% in 3 years, hitting an all-time high in 2021 of $23.1 billion raised. With more funding pouring in each year and over 2,261 ongoing global clinical trials in regenerative medicine, the market is expected to reach $34.31 billion in 2030. With this immense growth potential, the industry is reaching a tipping point heading towards commercialization.Over 800 Prescription Medications Got More Expensive in January 2022. The list prices for 810 prescription drugs increased by an average of 5.1 percent between Dec. 29 and Jan. 31, according to a GoodRx report released Feb. 4. Of the 810 medications that saw price increases in January, 791 were brand drugs, 19 were generics, 199 were specialty drugs and 84 were healthcare practitioner-administered drugs. The 791 brand drugs' prices increased by an average of 4.9 percent, and the 19 generic drugs' prices increased by an average of 12.6 percent. Price hikes in January 2022 were on par with January 2021, which saw 832 price hikes. In January 2022, drug prices rose by an average of 5.1 percent, half a percentage greater than in January 2021. The price hikes came from 155 drugmakers.New Exposé Reveals Pharmacy Benefit Manager Tactics That Hurt Patients, Providers, Employers, and Taxpayers. The report, “Pharmacy Benefit Manager Exposé: How PBMs Adversely Impact Cancer Care While Profiting at the Expense of Patients, Providers, Employers, and Taxpayers,” was commissioned by the Community Oncology Alliance (COA) and written by industry experts at the law firm of Frier Levitt, LLC. It provides a comprehensive exposé and legal analysis of the most pervasive and abusive PBM tactics, highlighting the adverse impact they have on patients, providers, and health care payers (including Medicare, Medicaid, employers, and taxpayers). The goal is for the report to serve as an authoritative reference for policymakers, regulators, employers, and others seeking greater understanding of PBM behavior while also suggesting solutions to reshape the health care…

 News and notes from around the interweb:PBMs ranked by market share: CVS Caremark is No. 1. Three companies dominate the pharmacy benefit manager market, accounting for 79 percent of all prescription claims in 2020, according to data from Health Industries Research Companies, an independent, non-partisan market research firm. To assess market share, HIRC used self-reported data from twenty-nine pharmacy benefit manager leaders collected in December 2020 and January 2021.Documenting Patient Interventions Is Essential. The most common MRPs or medication-related problems included Beers criteria medications (mostly antidepressants, protein pump inhibitors, gabapentin, and opioids), medication omission, drug-condition interaction, duplicate therapy, medication nonadherence, drug-drug interactions, untreated conditions, dose that were too low, and doses that were too high. MRPs were also equally prevalent among face-to-face versus phone interventions. However, the presence of documentation in the “assessment” section of the comprehensive medication review (CMR) was higher when MTM was conducted via phone (42%) compared to face-to-face (28%).Join the Movement!Documents reveal the secrecy of America's drug pricing matrix. Several people who work in the industry, who asked not to be named due to the confidential nature of coalitions, said most employers, regardless of how big they are, have no idea what they're giving up when they enter coalitions. Once employers are locked into the coalition, they can't get a full second opinion on the drug prices they pay, experts said.Over 800 Prescription Medications Got More Expensive in January 2022. The list prices for 810 prescription drugs increased by an average of 5.1 percent between Dec. 29 and Jan. 31, according to a GoodRx report released Feb. 4. Of the 810 medications that saw price increases in January, 791 were brand drugs, 19 were generics, 199 were specialty drugs and 84 were healthcare practitioner-administered drugs. The 791 brand drugs' prices increased by an average of 4.9 percent, and the 19 generic drugs' prices increased by an average of 12.6 percent. Price hikes in January 2022 were on par with January 2021, which saw 832 price hikes. In January 2022, drug prices rose by an average of 5.1 percent, half a percentage greater than in January 2021. The price hikes came from 155 drugmakers.As It Mulls Whether to Grant Cert in ERISA Case on PBM Fiduciary Liability, Supreme Court Seeks Government's Input. In December, the Supreme Court requested that U.S. Solicitor General Elizabeth Prelogar file a brief in John Doe 1 v. Express Scripts Inc., weighing in on whether the Court should hear a case about prescription drug costs. If the Supreme Court adopts the petitioners' position, pharmacy benefit managers (PBMs) could face significant legal exposure under ERISA for decisions that affect prescription drug prices.The Certified Pharmacy Benefits Specialist (CPBS) educational offering includes knowledge that is critical to effective management of the pharmacy and medical drug benefit. If you want to learn more, click here.

 News and notes from around the interweb: Billionaire Mark Cuban steps up assault on US prescription drug prices. In an interview with Pharmacy Times, Ron Lanton III, Esq, principal at Lanton Law, said entrepreneur Mark Cuban's new venture into the pharmacy field is very interesting, although it maybe just another player in the mail-order pharmacy market. In the interview, Lanton discussed the company's steep discounts on drugs in a myriad of disease states, as well as the company's pharmacy benefits manager, which is expected to be operational in 2023.Is a 90-Day Supply the Best Option to Improve Medication Adherence? Medication nonadherence results in upwards of 100,000 deaths per year and billions in health care spending annually. Whether it is a newly discovered medication or a tried-and-true remedy of the past, a medication only works when it is taken correctly. Medication adherence is essential for each medication to have its therapeutic effect in every patient. Interventions to improve medication adherence may have a greater impact on individual patients and the population as a whole than any novel treatment or therapy. To address nonadherence and remove the potential barrier of accessibility to medications, 90-day supplies are commonly offered as a solution.Join the Movement!Documents reveal the secrecy of America's drug pricing matrix. Several people who work in the industry, who asked not to be named due to the confidential nature of coalitions, said most employers, regardless of how big they are, have no idea what they're giving up when they enter coalitions. Once employers are locked into the coalition, they can't get a full second opinion on the drug prices they pay, experts said.3 reasons to optimize pharmacy benefits before the next open enrollment. Drug spending in the U.S. ballooned to more than $535 billion in 2020 and was projected to increase by another 4-6% by the end of 2021. Two culprits include faster price increases and higher growth in utilization. With drug costs and pharmacy spend on the rise, reducing the cost of Rx benefits is a top priority for many of your self-funded employer clients. To put it simply, sticking with the status quo is not the best option in 2022. Here are three reasons why.Issues Arise as Health Plans Begin Covering At-Home COVID-19 Tests. While plan sponsors and issuers were adjusting their benefits to cover the cost of COVID-19 at-home tests, the administration moved forward with President Joe Biden's order that the federal government purchase five hundred million at-home rapid COVID-19 testing kits to be sent free of charge to Americans who request them. The administration's action is in addition to its policy of allowing Americans to buy and get reimbursed through private insurance for at-home tests.The Certified Pharmacy Benefits Specialist (CPBS) educational offering includes knowledge that is critical to effective management of the pharmacy and medical drug benefit. If you want to learn more, click here.