PhRMA

MARCH 12, 2025

Specifically, HCPs raised concerns over how pharmacy benefit managers (PBMs) and insurers inappropriately use utilization management tools, like prior authorization, to deny or delay care, ultimately harming the patient and impacting patient access to care.

Patient Care 301

Patient Care Insurance 301

PhRMA

OCTOBER 18, 2022

Insurers and pharmacy benefit managers (PBMs) continue to shift more and more costs to patients. For seniors who rely on Medicare Part D, the out-of-pocket costs for medicines can sometimes be a barrier. And a new analysis from the Medicare Payment Advisory Commission (MedPAC) shows why this is a problem that must be addressed.

Insurance 275

Insurance 275

STAT

MARCH 20, 2025

TriCare, the federal health insurer for the military, has temporarily stopped paying the medical claims of pain management device maker Zynex Medical. 

Insurance 113

Insurance 113

STAT

MAY 1, 2025

The conglomerate set aside $448 million in the first quarter to cover medical claims from ACA members that won’t be covered by insurance premiums.  CVS expects to lose up to $400 million this year in its ACA plans.   Continue to STAT+ to read the full story…

Insurance 129

Insurance 129

PhRMA

DECEMBER 14, 2022

A survey of more than 5,000 Americans conducted with Ipsos found that insured Americans want better health care coverage.

Insurance 276

Insurance 276

PhRMA

DECEMBER 8, 2022

A survey of more than 5,000 Americans conducted with Ipsos found that 30% of insured Americans say they face a financial barrier to care, such as unaffordable out-of-pocket costs or a lack of savings to pay for emergency or unforeseen expenses.

Insurance 262

Insurance 262

Drug Topics

JULY 27, 2023

The National Rosacea Society found that a lack of health insurance or the high cost of a copay caused 52% of respondents to avoid obtaining medical care for their rosacea.

Insurance 247

Insurance 247

PhRMA

MARCH 17, 2025

Half of every dollar spent on medicines goes to entities that don’t make medicine—like pharmacy benefit managers (PBMs) and insurers who are aggressively consolidating their control over health care and hospitals, clinics and for-profit pharmacies in the 340B markup program.

Insurance 266

Insurance Hospitals 266

The Checkup by Singlecare

MAY 28, 2025

Fortunately, many insurance plans help cover the cost of Adderall. Ultimately, the persons out-of-pocket price for Adderall depends on several factors set by the insurance provider. Does insurance cover Adderall? Khurana says that health insurance plans are more likely to cover generic drugs when a generic version is available.

Insurance 59

Insurance Insurance Coverage Health Insurance Companies FDA 59

STAT

DECEMBER 11, 2024

A proposed Senate bill that would prohibit companies that control health insurers or pharmacy benefit managers from owning pharmacies rattled investors on Wednesday, but some Wall Street analysts believe the legislation is unlikely to gain much traction, at least for now.

Insurance 125

Insurance Independent Pharmacies 125

Drug Topics

DECEMBER 19, 2023

Social determinants of health (SDOH), such as financial disparities or lack of insurance, create barriers to accessing breakthrough therapies like BTK inhibitors among patients with CLL and SLL.

Insurance 551

Insurance 551

STAT

MARCH 3, 2025

The Department of Justice is investigating Semler Scientific for possible violations of a federal anti-fraud law related to its marketing of a product known as QuantaFlo, a test used in the diagnosis of peripheral artery disease by UnitedHealth Group and other large insurers.

Insurance 139

Insurance 139

The Guardian - Pharmaceutical Industry

NOVEMBER 5, 2024

Pharmaceutical’s weight loss pill described as ‘underwhelming’, also piling pressure on share price AstraZeneca shares tumbled on Tuesday wiping £14bn off the value of Britain’s biggest drug maker, after a report that dozens of senior executives at its China unit could be implicated in an insurance fraud case in the country’s pharmaceutical sector.

Insurance 110

Insurance 110

Drug Topics

MARCH 20, 2023

The company also will establish a $35 out-of-pocket price cap for for all patients with commercial insurance that use Latnus

Insurance 468

Insurance 468

Drug Topics

AUGUST 21, 2023

A recent study found that Infants younger than 3 months, those born prematurely, and those who were publicly insured were at a higher risk for intubation.

Insurance 459

Insurance 459

Pharmacy Times

JUNE 2, 2025

The CDC has updated its COVID-19 vaccine guidance for children and pregnant individuals, sparking a debate among health experts and concerns over insurance coverage.

Insurance Coverage 141

Insurance Coverage Vaccines Insurance 141

Drug Topics

MAY 25, 2023

Iowa's Department of Health and Human Services, which manages the two health insurers that delivered care to adults and children in the state’s Medicaid program last year, was alleged to provide inadequate mental and behavioral health care to children on Medicaid.

Insurance 468

Insurance 468

Drug Topics

APRIL 27, 2023

The average annual healthcare spending for people with employer-sponsored insurance spending increased from $5,630 in 2020 to $6,467 in 2021. After decreasing in 2020, per person healthcare spending increased 15%.

Insurance 452

Insurance 452

Drug Topics

MAY 8, 2023

A new CDC report on data collected by the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy, indicates that medication for opioid use disorder is more often given to individuals who are White, older, and have private insurance.

Insurance 469

Insurance 469

PhRMA

NOVEMBER 16, 2022

There is only one place in the health care system where middlemen refuse to share negotiated prices with patients, and that’s at the pharmacy counter. A new report reveals how this harmful tactic leads to higher costs for patients.

Insurance 296

Insurance 296

The Checkup by Singlecare

APRIL 4, 2025

Bonjesta costs about $490 without insurance for 30, 20-20 mg extended- release tablets. How much does Bonjesta cost without insurance? The copays for Bonjesta, with insurance and Medicare, vary by plan. Drug costs may be affected by differences in insurance plans and specific drug formularies. RELATED: What is Bonjesta ?

Insurance 52

Insurance Health and Personal Care Stores Insurance Coverage Documentation 52

PhRMA

MARCH 2, 2023

Health plans are increasingly using deductibles and coinsurance to shift more of the cost of care to chronically ill patients taking brand medicines.

Insurance 319

Insurance 319

Drug Topics

APRIL 9, 2024

Brian Rakers, senior vice president of distribution and member support at Pharmacists Mutual Insurance Group, talked cybersecurity during a session at AAP 2024.

Independent Pharmacies 407

Independent Pharmacies Insurance 407

The Checkup by Singlecare

DECEMBER 2, 2024

Plus, we’ve got tips on how to save, even if you don’t have insurance. How much does Combivent Respimat cost without insurance? For people who don’t have insurance or Medicare—or whose plans don’t cover Combivent Respimat—the average retail price is $636 for a 4 gm of 20–100 mcg/act inhaler with 120 inhalations. Many times, yes.

Insurance 52

Insurance Insurance Coverage Dosage FDA 52

STAT

DECEMBER 11, 2024

would force the companies that own health insurers or PBMs to divest their pharmacy businesses within three years. Federal Trade Commission , The Wall Street Journal reports. A Senate bill, sponsored by Sens. Elizabeth  Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.),

Insurance 108

Insurance 108

STAT

DECEMBER 12, 2024

Like many Americans, Holden Karau said she was fed up with health insurance. The software engineer’s disillusionment began in 2019, when her insurer, UnitedHealthcare, balked at covering physical therapy after she was hit by a car and could not walk.

Insurance 144

Insurance 144

STAT

APRIL 17, 2025

For a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force.

Insurance 138

Insurance 138

The Checkup by Singlecare

DECEMBER 30, 2024

Without insurance, the average retail price for two FreeStyle Libre 3 Plus sensors, a 28-day supply, is $232. The price without insurance adds up to just over $3,000 for one year. Is FreeStyle Libre 3 covered by insurance? Insurance plans are different and may or may not cover the FreeStyle Libre 3 Plus sensor.

Insurance 52

Insurance Insurance Coverage FDA 52

The Checkup by Singlecare

JUNE 6, 2025

Although insurance plans may cover Ozempic to treat Type 2 diabetes, coverage for fatty liver disease might not be so straightforward. Several factors that can affect coverage include someone’s health history, specific insurance plan, and what it’s prescribed for. Does insurance cover Ozempic for fatty liver disease?

Insurance 52

Insurance FDA Health Insurance Companies Labelling 52

The Checkup by Singlecare

APRIL 9, 2025

Without insurance, Depakote costs $769 for 90, 500 mg delayed-release tablets. How much does Depakote cost without insurance? Without insurance, the price of Depakote may vary depending on certain factors. Without insurance, the price of Depakote may vary depending on certain factors. RELATED: What is Depakote?

Insurance 52

Insurance Mail-Order Pharmacies Insurance Coverage Dosage 52

Drug Topics

SEPTEMBER 11, 2024

To further understand PBM market concentration, researchers separately analyzed commercial insurance, Medicare Part D, and Medicaid managed care market strategies of the 3 biggest PBMs.

Insurance 346

Insurance 346

The Checkup by Singlecare

APRIL 24, 2025

Without insurance, the average retail price of Actos is $2,111 for 90, 30 mg tablets. How much does Actos (pioglitazone) cost without insurance? Without insurance, the price of Actos can vary depending on the quantity, dosage, and pharmacy you purchase the drug from. Without insurance, Actos costs $2,111 for 90, 30 mg tablets.

Insurance 52

Insurance Mail-Order Pharmacies Insurance Coverage Dosage 52

Drug Topics

APRIL 16, 2024

Findings indicating that socioeconomic disparities widened gaps in vaccination timeliness signal the need for increased efforts to promote timely vaccination among children from families with lower income and those without private insurance.

Vaccines 386

Vaccines Insurance 386

Drug Topics

FEBRUARY 17, 2025

The Institute for Clinical and Economic Review assessed the formularies of 11 payers, covering 57 million people, to determine access to drugs that the organization had reviewed for cost effectiveness in 2022.

Insurance 247

Insurance 247

The Checkup by Singlecare

JUNE 5, 2025

Without insurance, brand-name Vasotec costs about $1,025 for 30, 20 mg tablets. Is Vasotec covered by insurance? Vasotec insurance coverage varies by plan. How much does Vasotec cost without insurance? Thirty 20 mg tablets of brand-name Vasotec cost an average of $1,025 without insurance.

Insurance 52

Insurance Insurance Coverage Dosage Labelling 52

PhRMA

OCTOBER 5, 2022

Insurer-imposed barriers like high deductibles and coinsurance shift the cost of life-saving care onto patients. Manufacturers and others have stepped forward to assist patients who face high out-of-pocket costs, using programs like copay coupons to help eligible, commercially insured patients afford their out-of-pocket costs.

Insurance 310

Insurance 310

STAT

OCTOBER 24, 2024

A federal watchdog found that Medicare Advantage insurers collected billions of dollars in dubious payments from Medicare in a single year by using home visits and medical chart reviews to diagnose patients with conditions for which they received no follow-up care.   

Insurance 145

Insurance Medical Records 145