Pharmacy Benefits Management
So-called "pay for delay" deals between patent-holding pharmaceutical firms and would-be generics makers can now be challenged on antitrust grounds, although they are not necessarily anti-competitive, the U.S. Supreme Court has ruled.
Starting next year, the Affordable Care Act sets maximum limits on how much consumers can be required to pay out-of-pocket annually for their medical care. But some people with high drug costs may find the limits don't protect them yet.
Consumer advocates and some lawmakers are promoting a new bill they say would save Medicare $141 billion over the next decade by requiring prescription drug rebates for Medicaid-Medicare eligible patients and low-income Medicare beneficiaries.
A federal appeals court in Boston has upheld a lower court ruling requiring Pfizer to pay Kaiser Foundation Health Plan $142 million for alleged fraudulent marketing of the epilepsy drug Neurontin, and also let related lawsuits filed by Aetna and a self-funded employer go forward.
One example of the dilemmas posed by the rise of personalized medicine is Alzheimer's Disease: the ApoE genetic test can predict early onset of it, but there's still no effective therapy to stop dementia.
After President Obama suggested reducing "taxpayer subsidies to prescription drug companies" as an avenue for Medicare savings in his State of the Union speech, the Pharmaceutical Research and Manufacturers of America trade group went on the offensive, saying it would "upend the successful Medicare Part D prescription drug program by imposing government price controls on it" and "harm Part D's competitive dynamics, yielding higher premiums."
Web insurance marketplace and health insurance exchange company Connecture announced earlier this month that it had acquired DRX (formerly DestinationRx), in a deal that will join two companies that offer online enrollment and insurance marketplaces for commercial plans and government insurers alike.
Ahead of oral arguments over pharmaceutical patent settlements in the Supreme Court, a Federal Trade Commission 
The St. Louis-based insurer Centene said it's buying a comprehensive speciality drug company called AcariaHealth for $152 million, as part of its plan for treatment of complex illnesses.
A diverse group of more than 350 healthcare, patient, veterans and business organizations on Tuesday urged Congressional leaders to reject any proposal to turn the Medicare Part D plan into one that resembles the rebates structure of Medicaid drug programs.
Insurance coverage for tobacco cessation varies widely and is often explained in convoluted and occasionally contradictory contract language, a study of 39 health plans has found.
With the passage of a ballot initiative this month, Massachusetts became the latest state to allow the use of marijuana for medical purposes, joining 17 others and the District of Columbia.
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