- UnitedHealth without Medco—Tough talk about the upcoming renewal
- Service Fees without Penalties—OIG gives the thumbs-up to a manufacturer
- AMP without Guidance—CMS will perhaps release the rules soon (maybe)
- A World without Chains—You may not like it
UnitedHealth Enters Drug Benefits Business
UnitedHealth Group's (NYSE:UNH) OptumRx PBM is “very interested in the employer market” and is “getting very aggressive on bidding some very large accounts,” according to OptumRx CEO Jacqueline Kosecoff. Right now, I estimate OptumRx to be the fourth largest PBM overall, but the largest second-tier player. Taking back the commercial business from Medco Health Solutions (NYSE:MHS) would make it a legitimate one of the Big Four. As you may recall, Medco recently lost the FEP mail/specialty business to CVS Caremark (NYSE:CVS) per Interpreting Caremark’s Big Win over Medco. OptumRx also recently launched its own preferred network design for Medicare Part D (as I highlighted in 2011 Part D Market Share: A Win for Humana and Walmart).
OIG Issues Advisory Opinion on Manufacturer-Subsidized Patient Reminder Program
The good folks at Hyman, Phelps & McNamara provide a useful synopsis of a favorable Advisory Opinion from the Office of the Inspector General (OIG) regarding a manufacturer-sponsored patient reminder program for a vaccine. Good news for pharmaceutical manufacturers that provide bona fide service fees to retail or specialty pharmacies. As the lawyers note: “With regard to the antikickback law, it is encouraging that the OIG has recognized that these programs have a public health benefit and may be structured in a non-abusive, transparent manner that does not influence any treatment decisions.”
An Update on the Pending AMP Rule – Are the Rumors True?
Chris Cobourn of CIS catches up on the latest rumors that CMS may one day actually issue the Average Manufacturer Price (AMP) rules. Apparently, the rule has been written but now must go through 84 layers of review. See What’s Happening with AMP and Pharmacy Profits!! for background and context.
Imagining a world without chain stores
This opinion piece from The Washington Post defends the economic benefits of chain stores for consumers. The brief description of 1930s-era legislation against chain stores reminds me of today’s legislative battles against mail-order and chain pharmacies. Independent pharmacy owners will find much to hate in this article.
If You Think Accountants Are Hilarious, Try These Guys
Americans—or at least three anonymous judges—have spoken. According to today's Wall Street Journal, Michael L. Shaw of GlaxoSmithKline is ... America's Funniest Compliance Officer! Watch some of the "humor" at your own risk in the video below. IMPORTANT: This blog may contain information that is unsuitable for overly sensitive persons with low self-esteem, the inability to read beyond a headline, or no sense of humor. If you are not the intended reader of this disclaimer, then any dissemination, distribution or copying of this disclaimer is both nonsensical and unauthorized, either explicitly or implicitly, and constitutes an irritating social faux pas.