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Pharmacy & PBM
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PBMs exclude 600+ drugs from 2026 formularies amid pricing shifts
Major PBMs Caremark, Express Scripts and Optum Rx each excluded over 600 drugs from 2026 formularies as pricing models challenge traditional strategies.
Read full articleCVS threatens to close 134 Tennessee stores over PBM separation bill
CVS claims it will close 134 locations and cut 2,000 jobs if Tennessee passes SB 2040 requiring pharmacy owners to separate from PBMs.
Read full article2026 PBM reforms mandate rebate pass-through, flat fees
Consolidated Appropriations Act requires PBMs to pass 100% of rebates to employers and shift to flat fee models starting in 2028.
Read full articleFederal PBM transparency rules target commercial markets
New federal law extends PBM reforms to commercial insurance markets for the first time, requiring transparency and rebate pass-through by 2028.
Read full articleStelara biosimilar launches at 96% below list price
Direct-to-patient Stelara biosimilar available for $360/dose challenges rebate-driven formulary models with dramatically lower pricing.
Read full articlePBMs favor affiliated biosimilars over lower-cost alternatives
PBMs prioritize private-label biosimilars tied to parent companies for Humira and Stelara despite competing products with lower list prices.
Read full articleExpress Scripts expands formulary exclusions for generics, diabetes drugs
Express Scripts significantly expanded 2026 exclusions including multisource generics, older brands and diabetes treatments.
Read full articlePharmacy groups urge passage of 2026 spending bill with PBM reforms
Six major pharmacy organizations support H.R. 7148 containing PBM reforms to improve Medicare patient access to chosen pharmacies.
Read full articlePBMs exclude 600+ drugs from 2026 formularies amid pricing shifts
Major PBMs Caremark, Express Scripts and Optum Rx each excluded over 600 drugs from 2026 formularies as pricing models challenge traditional strategies.
Read full articleCVS threatens to close 134 Tennessee stores over PBM separation bill
CVS claims it will close 134 locations and cut 2,000 jobs if Tennessee passes SB 2040 requiring pharmacy owners to separate from PBMs.
Read full article2026 PBM reforms mandate rebate pass-through, flat fees
Consolidated Appropriations Act requires PBMs to pass 100% of rebates to employers and shift to flat fee models starting in 2028.
Read full articleFederal PBM transparency rules target commercial markets
New federal law extends PBM reforms to commercial insurance markets for the first time, requiring transparency and rebate pass-through by 2028.
Read full articleStelara biosimilar launches at 96% below list price
Direct-to-patient Stelara biosimilar available for $360/dose challenges rebate-driven formulary models with dramatically lower pricing.
Read full articlePBMs favor affiliated biosimilars over lower-cost alternatives
PBMs prioritize private-label biosimilars tied to parent companies for Humira and Stelara despite competing products with lower list prices.
Read full articleExpress Scripts expands formulary exclusions for generics, diabetes drugs
Express Scripts significantly expanded 2026 exclusions including multisource generics, older brands and diabetes treatments.
Read full articlePharmacy groups urge passage of 2026 spending bill with PBM reforms
Six major pharmacy organizations support H.R. 7148 containing PBM reforms to improve Medicare patient access to chosen pharmacies.
Read full articleStay ahead of Pharmacy & PBM in 3 minutes a day.
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