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What We’re Reading: PBM Probe Stalls; CA’s Endemic Policy; Recalled Infant Formulas
A proposed probe of pharmacy benefit managers (PBMs) by the Federal Trade Commission did not win enough votes to go forward; California exits the crisis phase of the pandemic; Abbott infant formula has been recalled after 1 death.
FTC PBM Probe Will Not Move Forward
With a vote that failed to reach a consensus, the Federal Trade Commission (FTC) halted a probe into whether reimbursement rates set by pharmacy benefit managers (PBMs) unfairly favor affiliated pharmacies at the expense of independent or specialty ones, Bloomberg Law reports. PBMs manage prescription drug benefits for health insurers and Medicare Part D plans, and have traditionally lacked strong federal oversight. The 2-to-2 vote was along party lines with Republican commissioners voting against, claiming the study’s plans do not adequately call for measuring how these middlemen could influence out-of-pocket costs.
California Moves to COVID-19 "Endemic"
California has become the first state to adopt an endemic virus policy against COVID-19, which includes emphasizing prevention and quickly responding to outbreaks as opposed to mandated masking and business shutdowns, according to The Associated Press. The plan was introduced by Governor Gavin Newsom (D) yesterday, who said the state was moving past the crisis phase of the pandemic and into a phase of living with the virus. By definition, a virus becomes endemic when it exists in a community but becomes manageable as immunity builds. The state’s emergency orders will not be immediately lifted, however.
Popular Infant Formula Recalled
The FDA has warned parents not to use 3 powdered infant formulas manufactured by an Abbott plant in Michigan as they have been tied with bacterial contamination, The Associated Press reports. Four infants have been hospitalized after injesting the formula, one of whom died. One reported case involved salmonella and the other 3 Cronobacter sakazakiim—a rare germ linked with blood infections. Abbott is recalling all potentially impacted formulas, which include certain lots of Similac, Alimentum, and EleCare with expiration dates of April 1, 2022, or later. The FDA is also inspecting the company’s Michigan plant.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being
March 14th 2025Mehmet Oz, MD, the nominee to lead CMS under the Trump administration, testified in a confirmation hearing before the Senate Finance Committee, where he found common ground on improving outcomes through healthier lifestyle choices but encountered repeated questions on potential Medicaid cuts.
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