With Lawsuits, Regulations, PBMs Looking for New Ways of Doing Business

What began with an eye-opening audit for the Ohio Bureau of Workers' Compensation in 2018 has turned into a growing amount of litigation and legislation that could soon force major changes to pharmacy benefits managers' business model. A lawsuit brought by the Ohio attorney general on behalf of the BWC last year, a result of the audit, was one of the first in the country to question PBMs' drug price management efforts. The suit charges that OptumRx, one of the largest PBMs in the country, overcharged the state-run comp insurance system more than $15 million and failed to pass...