Good things are happening! One state’s pharmacies get a lifeline, an Ivy League gets schooled in managing workers’ retirements, Airbnb owns up to its true prices, and a pharma giant will pay a $350 million fine for its shady prescriptions.
Bye Bye, Drug-Deal Markups
For years, Ohio’s Medicaid was shelling out more for prescriptions than it needed to — and pharmacies and taxpayers were paying the price. But not anymore.
Ohio, like many states, traditionally used intermediaries between insurers and pharmacies, called Pharmacy Benefit Managers, to determine which drugs are covered and negotiate their cost. But the state’s Medicaid system and its pharmacies got stiffed by the opaque middlemen, so in 2022, the Ohio Medicaid Department decided to reform the system, introducing a single PBM that doesn’t have any financial stakes in any contracted pharmacies.
A few reactions... One, PBMs, another example of Rube Goldberg-esque nature of (grossly inefficient) health care in America. Two, the Supreme Court revived the Cornell University employees' case after lower courts had dismissed it...? Thank goodness, but what was behind that move, I would have expected the Roberts court to have refused to pick it up. Three, the Justice Dept. and the FTC moving against Walgreen's and Airbnb, respectively? How is it that Don Trump's mafia foot soldiers let that get through? Surely we can expect no more such actions.