As Big PBMs Dangle On A Hook, Smaller Players Surface For A Bite
As Modern Healthcare explains, the newer entrants are trying to set themselves apart from giants CVS, Cigna, and UnitedHealth and are passing along drug rebates, disclosing cost negotiations, reimbursing pharmacies at higher rates, and more.
Modern Healthcare:
Insurers, Employers See Payoffs Switching To Smaller PBMs
Smaller pharmacy benefit managers may be having more than a moment as some health insurers and employers show the major players the door. Insurance companies and employers fed up with commonplace industry practices are ditching PBMs owned by CVS Health, Cigna Group and UnitedHealth Group, and instead are inking contracts with smaller competitors pushing transparent business models. (Berryman, 7/11)
Bloomberg:
Therapy Startup Headway Nabs $2.3 Billion Valuation
Mental health startup Headway is raising a new funding round valuing the company at $2.3 billion, according to people familiar with the matter, roughly doubling its valuation from a year earlier. The financing brings in about $100 million for Headway, which connects people with therapists and can handle tasks like looking up benefits and booking appointments. (Roof, 7/12)
Modern Healthcare:
Pennant Group To Acquire Signature Healthcare Assets For $80M
Healthcare services provider Pennant Group has agreed to buy some assets from home health and hospice company Signature Healthcare at Home for $80 million. Pennant Group entered into two separate purchase agreements, it said Thursday. The deals, which are each subject to regulatory approval, would expand its footprint by 13 locations across Idaho, Oregon and Washington, according to a news release. (Eastabrook, 7/11)
Reuters:
Indivior Shares Dive On Profit Warning, Dropping Of Schizophrenia Drug
Drugmaker Indivior Plc (INDV.L) slashed its 2024 profit forecast while signaling a slowdown in sales of its top-selling opioid addiction treatment, and said it would discontinue sales of its schizophrenia drug Perseris, prompting its shares to plunge 44% on Tuesday. Indivior's Sublocade drug has faced intense competition from the launch of a rival, as well as the end of pandemic-relief measures that has led to loss of coverage in the United States for some people enrolled in government-backed Medicaid plans. (Anilkumar, 7/11)
Also —
KFF Health News:
States Set Minimum Staffing Levels For Nursing Homes. Residents Suffer When Rules Are Ignored Or Waived
For hours, John Pernorio repeatedly mashed the call button at his bedside in the Heritage Hills nursing home in Rhode Island. A retired truck driver, he had injured his spine in a fall on the job decades earlier and could no longer walk. The antibiotics he was taking made him need to go to the bathroom frequently. But he could get there only if someone helped him into his wheelchair. By the time an aide finally responded, he’d been lying in soiled briefs for hours, he said. It happened time and again. (Rau, 7/12)
KFF Health News:
How To Find A Good, Well-Staffed Nursing Home
Few people want to go into a nursing home, but doing so can be the right choice if you or a loved one is physically or cognitively disabled or recovering from surgery. Unfortunately, homes vary greatly in quality, and many don’t have enough nurses and aides to give residents the care they need. (Rau, 7/12)
