Client Alert: Prime Therapeutics Notice of Audit or Termination of Agreement — What You Need to Know

January 30, 2017 — It has come to our attention that Prime Therapeutics (Prime), a Pharmacy Benefit Manager (PBM) that maintains contractual agreements with many independent pharmacies nationwide, is in the process of issuing both audit and termination letters to many of its contracted pharmacies. Receipt of either a notification of audit or a termination is [...]

Client Alert: DIR Report Demonstrates Downside of Drug Rebates for Consumers and Medicare Program

January 26, 2017 — Earlier this month, the U.S. Centers for Medicare & Medicaid Services (CMS) issued an analysis of direct and indirect remuneration (DIR) fees. The data presented in the report makes clear that despite the claims of pharmacy benefit managers (PBMs) to the contrary, DIR fees do not reduce the costs of drugs for [...]

Express Scripts Subpoenaed as the Feds Initiate Investigations into its Relationships with Drug Manufacturers and Others

October 31, 2016 — The U.S. Department of Justice (DOJ) and two U.S. Attorney's offices have officially entered the national discussion on drug pricing and the role of Pharmacy Benefit Managers (PBMs) with the initiation of investigatory proceedings against Express Scripts. In a recent Securities and Exchange Commission filing, Express Scripts disclosed that it has received [...]