Oklahoma and South Carolina are among nine states that use some form of provider-based reference pricing to contain spending growth in their state employee health plans. Officials in those states note ...

FTC settlement frameworks for major PBMs mandate transparency to plan sponsors, fee-based remuneration, limits on spread pricing, and reshoring of offshore GPO functions, but allow employer opt-outs.

Reference-based pricing (RBP) is rapidly gaining traction as employers search for sustainable healthcare cost-control strategies. Yet, widespread confusion, persistent myths, and implementation ...

CMS’s proposed GLOBE and GUARD models represent an evolution in the Trump Administration’s approach to international reference pricing. However, their operational differences underscore the ...

For decades, the U.S. stood apart from the pharmaceutical world: It did not formally tie drug prices to what other countries were paying. Instead, pricing evolved through market competition, rebates ...

Pricing expert Rafi Mohammed warns against hasty changes to keep customers. Rafi Mohammed, founder of the consulting firm Culture of Profit, says a crisis or recession is not the time to panic and ...