Why PBMs, or pharmacy benefit managers, are the focus of new bills in Congress : Shots

Pharmacy benefit managers are middlemen who work with drug companies and insurers, helping set the retail prices for prescription drugs Americans rely on for their health. They’re now the subject of a number of new bills in Congress.

Robert F. Bukaty/AP

In recent months ominous ads about prescription drugs have flooded the TV airwaves. Perhaps by design, it’s not always clear who’s sponsoring the ads or why.

Or, for that matter, why now?

The short answer is that Congress is paying attention. House and Senate members from both parties have launched at least nine bills, parts of which may be packaged together this fall, that take aim at pharmacy benefit managers, companies that channel prescription drugs to patients. Here’s a primer to help you decipher what’s happening.

What are pharmacy benefit managers?
Known as PBMs, these companies were created in the 1960s to help employers and insurers select and purchase medications for their health plans. The industry mushroomed as prescription drug spending grew about 200-fold between 1967 and 2021. In addition to negotiating discounts with manufacturers, PBMs set payment terms for the pharmacies that buy and dispense the drugs to patients. In effect, they are the dominant middlemen among drugmakers, drugstores, insurers, employers, and patients.

New drugs. Cheaper drugs. Why not both?

How big is the PBM industry?
There are around 70 PBMs in the U.S. Through mergers, three of them — CVS Caremark, Optum Rx, and Express Scripts — have come to control 80% of the prescription drug market, and each brings in tens of billions of dollars in revenue annually. The PBMs control the drug pipeline from manufacturers to the pharmacy counter.

Their buying power allows them to obtain discounted drugs for health plans while setting prices and terms for sales at drugstores. The big three are part of massive conglomerates with important stakes in almost every sector of health care; each of them owns a powerful health insurer — Aetna, UnitedHealth, and Cigna, respectively — as well as pharmacies and medical providers.

For example, UnitedHealth contracts with 70,000 doctors, making it the biggest employer of physicians in the country. CVS Health, with the big pharmacy chain, also owns Caremark and Aetna. Secret price negotiations and hidden corners of each PBM-linked corporation make it hard to track where the money ends up.

Why am I seeing all these ads about PBMs?
Other sectors of health care are alarmed by the power of the PBMs and are appealing to the Biden administration and Congress to rein them in. Drugmakers are especially up in arms (more on that later), but employers, pharmacies, doctors, and even patients chafe at PBM practices like “spread pricing,” in which the companies pocket money negotiated on behalf of health plans.

Non-PBM-affiliated pharmacists, from mom and pop stores to large chains like Kroger, say the PBMs squeeze their businesses by forcing them to sign opaque contracts that include clawbacks of money long after sales take place. PBMs often steer patients using expensive drugs to their affiliated pharmacies, cutting revenue to independents.

Doctors say PBMs act as gatekeepers for the insurers they represent, blocking or slowing coverage of necessary drugs.

Finally, the pharmaceutical industry has lost a share of sales revenue to PBM middlemen in recent years — even while getting most of the bad publicity for high drug prices. (The median launch price for newly marketed brand-name drugs went from $2,100 to $180,000 a year between 2008 and 2021, yet net revenues for drug companies have stagnated in recent years.)

PBMs in some cases prefer high producer list prices, because the rebates that drugmakers pay the PBMs in exchange for favorable health plan coverage of their drugs often are calculated as a percentage of those list prices.

Who’s paying for the ads?
The Pharmaceutical Research and Manufacturers of America, the trade group for most of the big drug companies, is the top driver of the anti-PBM campaign. Some of the ads are sponsored by the PBM Accountability Project, a pop-up lobby, funded partly by the drug industry, that includes unions and patient advocates whose membership complains of restrictive PBM and insurance industry policies.

In one PhRMA ad, a smarmy guy in a suit snatches away a young woman’s prescription. The Pharmaceutical Care Management Association, the PBM trade group, has responded with its own ads, blaming drug companies for high prices and for “targeting your pharmacy benefits.” AHIP, the health insurance lobby, has piled on with its own campaign.

Over-The-Counter (Otc) Medications For Common Ailments

OvertheCounter Medications Divers Alert Network

Introduction

In today’s fast-paced world, it’s common to experience minor ailments that can be easily treated with over-the-counter (OTC) medications. These medications are easily accessible and can provide relief for a variety of common health issues. In this article, we will explore some of the most commonly used OTC medications for common ailments.

Headaches and Migraines

Headaches and migraines are a common ailment that can significantly impact our daily lives. OTC pain relievers such as acetaminophen and ibuprofen can provide effective relief. These medications work by reducing inflammation and blocking pain signals to the brain.

Allergies

Allergies can cause symptoms such as sneezing, itching, and watery eyes. OTC antihistamines like loratadine and cetirizine can help alleviate these symptoms by blocking the release of histamines in the body.

Cough and Cold

For cough and cold symptoms, OTC medications such as cough suppressants and decongestants can provide relief. Cough suppressants like dextromethorphan help to reduce coughing, while decongestants like pseudoephedrine can help relieve nasal congestion.

Heartburn and Indigestion

OTC antacids like calcium carbonate and magnesium hydroxide can provide quick relief for heartburn and indigestion. These medications work by neutralizing stomach acid and reducing the symptoms of acid reflux.

Upset Stomach

For symptoms of an upset stomach, OTC medications such as bismuth subsalicylate can be effective. This medication can help relieve symptoms of nausea, indigestion, and diarrhea.

Insomnia

If you’re having trouble sleeping, OTC sleep aids like diphenhydramine or doxylamine can help you get a good night’s rest. These medications work by blocking certain chemicals in the brain that cause wakefulness.

Muscle Pain and Inflammation

OTC topical analgesics like creams or ointments containing menthol or capsaicin can provide relief for muscle pain and inflammation. These products work by numbing the area or reducing inflammation, providing temporary relief.

Joint Pain

For joint pain, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. These medications can be taken orally or applied topically in the form of creams or gels.

Minor Skin Irritations

OTC hydrocortisone creams can be used to relieve minor skin irritations such as itching, redness, and inflammation. These creams work by reducing the activity of the immune system, which helps to alleviate these symptoms.

Conclusion

Over-the-counter medications can provide convenient and effective relief for common ailments. However, it’s important to follow the recommended dosages and consult a healthcare professional if symptoms persist or worsen. Remember to read and follow the instructions on the packaging, and always use OTC medications as directed.

Which OTC Meds Treat Heartburn? Health Life Media

Introduction

In today’s fast-paced world, it’s common to experience minor ailments that can be easily treated with over-the-counter (OTC) medications. These medications are easily accessible and can provide relief for a variety of common health issues. In this article, we will explore some of the most commonly used OTC medications for common ailments.

Headaches and Migraines

Headaches and migraines are a common ailment that can significantly impact our daily lives. OTC pain relievers such as acetaminophen and ibuprofen can provide effective relief. These medications work by reducing inflammation and blocking pain signals to the brain.

Allergies

Allergies can cause symptoms such as sneezing, itching, and watery eyes. OTC antihistamines like loratadine and cetirizine can help alleviate these symptoms by blocking the release of histamines in the body.

Cough and Cold

For cough and cold symptoms, OTC medications such as cough suppressants and decongestants can provide relief. Cough suppressants like dextromethorphan help to reduce coughing, while decongestants like pseudoephedrine can help relieve nasal congestion.

Heartburn and Indigestion

OTC antacids like calcium carbonate and magnesium hydroxide can provide quick relief for heartburn and indigestion. These medications work by neutralizing stomach acid and reducing the symptoms of acid reflux.

Upset Stomach

For symptoms of an upset stomach, OTC medications such as bismuth subsalicylate can be effective. This medication can help relieve symptoms of nausea, indigestion, and diarrhea.

Insomnia

If you’re having trouble sleeping, OTC sleep aids like diphenhydramine or doxylamine can help you get a good night’s rest. These medications work by blocking certain chemicals in the brain that cause wakefulness.

Muscle Pain and Inflammation

OTC topical analgesics like creams or ointments containing menthol or capsaicin can provide relief for muscle pain and inflammation. These products work by numbing the area or reducing inflammation, providing temporary relief.

Joint Pain

For joint pain, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. These medications can be taken orally or applied topically in the form of creams or gels.

Minor Skin Irritations

OTC hydrocortisone creams can be used to relieve minor skin irritations such as itching, redness, and inflammation. These creams work by reducing the activity of the immune system, which helps to alleviate these symptoms.

Conclusion

Over-the-counter medications can provide convenient and effective relief for common ailments. However, it’s important to follow the recommended dosages and consult a healthcare professional if symptoms persist or worsen. Remember to read and follow the instructions on the packaging, and always use OTC medications as directed.

OVERTHECOUNTER MEDICATIONS (OTC)Watsons Health

Introduction

In today’s fast-paced world, it’s common to experience minor ailments that can be easily treated with over-the-counter (OTC) medications. These medications are easily accessible and can provide relief for a variety of common health issues. In this article, we will explore some of the most commonly used OTC medications for common ailments.

Headaches and Migraines

Headaches and migraines are a common ailment that can significantly impact our daily lives. OTC pain relievers such as acetaminophen and ibuprofen can provide effective relief. These medications work by reducing inflammation and blocking pain signals to the brain.

Allergies

Allergies can cause symptoms such as sneezing, itching, and watery eyes. OTC antihistamines like loratadine and cetirizine can help alleviate these symptoms by blocking the release of histamines in the body.

Cough and Cold

For cough and cold symptoms, OTC medications such as cough suppressants and decongestants can provide relief. Cough suppressants like dextromethorphan help to reduce coughing, while decongestants like pseudoephedrine can help relieve nasal congestion.

Heartburn and Indigestion

OTC antacids like calcium carbonate and magnesium hydroxide can provide quick relief for heartburn and indigestion. These medications work by neutralizing stomach acid and reducing the symptoms of acid reflux.

Upset Stomach

For symptoms of an upset stomach, OTC medications such as bismuth subsalicylate can be effective. This medication can help relieve symptoms of nausea, indigestion, and diarrhea.

Insomnia

If you’re having trouble sleeping, OTC sleep aids like diphenhydramine or doxylamine can help you get a good night’s rest. These medications work by blocking certain chemicals in the brain that cause wakefulness.

Muscle Pain and Inflammation

OTC topical analgesics like creams or ointments containing menthol or capsaicin can provide relief for muscle pain and inflammation. These products work by numbing the area or reducing inflammation, providing temporary relief.

Joint Pain

For joint pain, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. These medications can be taken orally or applied topically in the form of creams or gels.

Minor Skin Irritations

OTC hydrocortisone creams can be used to relieve minor skin irritations such as itching, redness, and inflammation. These creams work by reducing the activity of the immune system, which helps to alleviate these symptoms.

Conclusion

Over-the-counter medications can provide convenient and effective relief for common ailments. However, it’s important to follow the recommended dosages and consult a healthcare professional if symptoms persist or worsen. Remember to read and follow the instructions on the packaging, and always use OTC medications as directed.

7Eleven launches store brand OTCs Store Brands

Introduction

In today’s fast-paced world, it’s common to experience minor ailments that can be easily treated with over-the-counter (OTC) medications. These medications are easily accessible and can provide relief for a variety of common health issues. In this article, we will explore some of the most commonly used OTC medications for common ailments.

Headaches and Migraines

Headaches and migraines are a common ailment that can significantly impact our daily lives. OTC pain relievers such as acetaminophen and ibuprofen can provide effective relief. These medications work by reducing inflammation and blocking pain signals to the brain.

Allergies

Allergies can cause symptoms such as sneezing, itching, and watery eyes. OTC antihistamines like loratadine and cetirizine can help alleviate these symptoms by blocking the release of histamines in the body.

Cough and Cold

For cough and cold symptoms, OTC medications such as cough suppressants and decongestants can provide relief. Cough suppressants like dextromethorphan help to reduce coughing, while decongestants like pseudoephedrine can help relieve nasal congestion.

Heartburn and Indigestion

OTC antacids like calcium carbonate and magnesium hydroxide can provide quick relief for heartburn and indigestion. These medications work by neutralizing stomach acid and reducing the symptoms of acid reflux.

Upset Stomach

For symptoms of an upset stomach, OTC medications such as bismuth subsalicylate can be effective. This medication can help relieve symptoms of nausea, indigestion, and diarrhea.

Insomnia

If you’re having trouble sleeping, OTC sleep aids like diphenhydramine or doxylamine can help you get a good night’s rest. These medications work by blocking certain chemicals in the brain that cause wakefulness.

Muscle Pain and Inflammation

OTC topical analgesics like creams or ointments containing menthol or capsaicin can provide relief for muscle pain and inflammation. These products work by numbing the area or reducing inflammation, providing temporary relief.

Joint Pain

For joint pain, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. These medications can be taken orally or applied topically in the form of creams or gels.

Minor Skin Irritations

OTC hydrocortisone creams can be used to relieve minor skin irritations such as itching, redness, and inflammation. These creams work by reducing the activity of the immune system, which helps to alleviate these symptoms.

Conclusion

Over-the-counter medications can provide convenient and effective relief for common ailments. However, it’s important to follow the recommended dosages and consult a healthcare professional if symptoms persist or worsen. Remember to read and follow the instructions on the packaging, and always use OTC medications as directed.

StockYour Home Pharmacy with These OTC Medications Survival Jack

Introduction

In today’s fast-paced world, it’s common to experience minor ailments that can be easily treated with over-the-counter (OTC) medications. These medications are easily accessible and can provide relief for a variety of common health issues. In this article, we will explore some of the most commonly used OTC medications for common ailments.

Headaches and Migraines

Headaches and migraines are a common ailment that can significantly impact our daily lives. OTC pain relievers such as acetaminophen and ibuprofen can provide effective relief. These medications work by reducing inflammation and blocking pain signals to the brain.

Allergies

Allergies can cause symptoms such as sneezing, itching, and watery eyes. OTC antihistamines like loratadine and cetirizine can help alleviate these symptoms by blocking the release of histamines in the body.

Cough and Cold

For cough and cold symptoms, OTC medications such as cough suppressants and decongestants can provide relief. Cough suppressants like dextromethorphan help to reduce coughing, while decongestants like pseudoephedrine can help relieve nasal congestion.

Heartburn and Indigestion

OTC antacids like calcium carbonate and magnesium hydroxide can provide quick relief for heartburn and indigestion. These medications work by neutralizing stomach acid and reducing the symptoms of acid reflux.

Upset Stomach

For symptoms of an upset stomach, OTC medications such as bismuth subsalicylate can be effective. This medication can help relieve symptoms of nausea, indigestion, and diarrhea.

Insomnia

If you’re having trouble sleeping, OTC sleep aids like diphenhydramine or doxylamine can help you get a good night’s rest. These medications work by blocking certain chemicals in the brain that cause wakefulness.

Muscle Pain and Inflammation

OTC topical analgesics like creams or ointments containing menthol or capsaicin can provide relief for muscle pain and inflammation. These products work by numbing the area or reducing inflammation, providing temporary relief.

Joint Pain

For joint pain, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. These medications can be taken orally or applied topically in the form of creams or gels.

Minor Skin Irritations

OTC hydrocortisone creams can be used to relieve minor skin irritations such as itching, redness, and inflammation. These creams work by reducing the activity of the immune system, which helps to alleviate these symptoms.

Conclusion

Over-the-counter medications can provide convenient and effective relief for common ailments. However, it’s important to follow the recommended dosages and consult a healthcare professional if symptoms persist or worsen. Remember to read and follow the instructions on the packaging, and always use OTC medications as directed.