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They started as simple claims processors. Then, over three decades of mergers and shifts in business strategy, pharmacy benefit managers emerged as powerful conglomerates with the ability to extract billions of dollars in payments from the largest players in the nation’s drug supply chain. And now, as their role in prescription drug pricing comes under increasing scrutiny, the nation’s biggest PBMs are changing shape again — this time by aligning themselves with the nation’s largest insurers. (Ross, 3/22)

It’s a rite of passage for executives in the hot seat: get hauled before Congress, sit for bipartisan tirades, squirm in the face of difficult questioning. Over the past six months, lawmakers have dragged in former Equifax CEO Richard Smith, Wells Fargo’s Tim Sloan, and Amtrak’s Richard Anderson. Facebook’s Mark Zuckerberg could be the next one up. (Mershon, 3/28)

The pharmaceutical industry's top trade group on Tuesday launched a new series of advertisements as part of its drug pricing campaign aimed at blaming cost increases on insurers and pharmacy benefit managers. Pharmaceutical Research and Manufacturers of America's (PhRMA) ads in print, radio, digital and social media highlight drug companies’ use of copay coupons to help people lower their deductibles. (Weixel, 3/27)

The Securities and Exchange Commission agreed to allow shareholders in five large drug makers to vote on a proposal demanding the companies compile reports about the risks created by high prices and also examine the extent to which pricing strategies propel executive compensation. The companies involved are AbbVie (ABBV), Amgen (AMGN), Biogen (BIIB), Bristol-Myers Squibb (BMY), and Eli Lilly (LLY). (Silverman, 3/26)

The U.S. renegotiation of its free trade agreement with South Korea will include provisions to boost American pharmaceuticals as well as a pending side agreement on currency, officials said Tuesday. The White House confirmed it had renegotiated elements of the Korea-U.S. Free Trade Agreement, known as KORUS, a day after Korean Trade Minister Kim Hyun-chong announced the move. (Elis, 3/27)

The Trump administration has issued a policy change that could drive up prices of certain biologic drugs, implementing a new industry-backed measure that overturns existing regulation that promoted lower prices. The move came after months of intense lobbying last year by pharmaceutical companies to overturn an Obama administration policy, introduced in 2015, that rewarded doctors with larger profits if they used the lowest-priced biosimilars, which are generic-like copies of brand-name biologic drugs. The rationale was that steering doctors to lower-priced products would compel drugmakers to cut prices to capture market share. (Walker, 3/22)

Biotech unicorn Moderna Therapeutics baffled its peers last month when it raised $500 million in a seventh round of venture financing. How, the question went, did the company sell investors on a $7.5 billion valuation despite outstanding questions about its science? STAT obtained Moderna’s investor slide deck, one in which the company predicts billion-dollar futures for drugs only tested in mice and argues its vaccines business can bring in $15 billion in annual revenue. Those promises didn’t sit well with some investors. (Garde, 3/27)

Emma Walmsley, the rookie chief executive of GlaxoSmithKline PLC, is giving the 300-year-old British drug giant’s ailing research-and-development operations a dose of bitter medicine. In the roughly one year that the 48-year-old former cosmetics executive has been in place, Ms. Walmsley has replaced nearly half of Glaxo’s top 125 executives, according to the company. She has reassigned or let go some 400 scientists in its drug-development unit, and another 100 science jobs are still on the line, according to people familiar with the matter. She is also shutting down more than two dozen clinical drug trials, as she narrows the focus of Glaxo’s drug-discovery portfolio. (Bisserbe and Lublin, 3/25)

Gilead Sciences completely transformed its business model last year when it got into the cell-therapy field by buying CAR-T developer Kite Pharma for $11.9 billion. Its top line won't be transformed so quickly. Kite’s cancer CAR-T, approved by the FDA in October, faced early reimbursement hurdles that hampered pickup. Declining sales in the company’s hepatitis C franchise drove Gilead’s total revenues for 2017 down 14% to $26.1 billion. (Weintraub, 3/27)

When it comes to philanthropy, the Arnolds are the only major game in town on drug pricing at a time when other billionaires are flocking to fund politically charged work on hot-button issues like climate change and gun control. But no one really seems to have a good idea of what exactly has motivated the Arnolds to take on drug pricing — or specifically what their endgame is to go about addressing it. (Robbins, 3/26)

In a setback to the Federal Trade Commission, a federal judge has dismissed the first-ever lawsuit filed by the agency against a drug maker for abusing the citizen’s petition process in order to thwart generic competition to a best-selling medicine. However, the FTC appears to have won a key point that may make it more difficult for drug makers to fend off such challenges in the future. And the judge left the door open for the FTC to refile its lawsuit, although an FTC spokeswoman declined to comment when asked if the agency will do so. (Silverman, 3/23)

Cut-price copies of an expensive Roche biotech drug for blood cancer have taken 80 percent of the British market since launching last year, saving the healthcare system 80 million pounds a year, experts said on Wednesday. The rapid adoption of two so-called biosimilar forms of rituximab from Celltrion and Novartis has been accompanied by discounts of 50-60 percent as the National Health Service (NHS) has used tenders to bring down costs. (Hirschler, 3/21)

Roche is back with more survival data for its Tecentriq-Avastin cocktail—and it’s more important survival data, too. Sunday night, the Swiss drugmaker revealed that in a phase 3 trial, the two meds, combined with chemo, had beaten out an Avastin-chemo combo at prolonging lung cancer patients' lives. The trial, focused on previously untreated non-small-cell lung cancer patients, showed that the survival benefit extended across various subgroups, and it was seen in patients with tumors expressing varying levels of PD-L1. (Helfand, 3/26)

Amid ongoing scrutiny of compounding pharmacies, the Food and Drug Administration has issued new draft guidelines to address a contentious debate: When should compounders use the same raw ingredients that are found in prescription medicines? Known in industry parlance as bulk substances, these ingredients figure prominently in discussions over the safe use of compounded medicines, as well as rising tensions between drug makers and compounders that are vying for some of the same patients. (Silverman, 3/23)

Pharmacy benefit managers are receiving $1.54 per pill from Ohio’s Medicaid program for a drug commonly used to treat depression. The state pharmacy association and operators of nearly two dozen pharmacies across the state say those same pharmacy benefit managers, or PBMs, are paying them only about 18 cents for each of those pills. (Candisky, 3/25)

A hospital-backed nonprofit generic drug manufacturer has radical plans for the drug industry as it prepares to launch operations later this year. Leaders of the drugmaker said they planned to publish drug prices in an effort to force more transparency in an industry that is known for being opaque. (Liss, 3/25)

Mayor Rahm Emanuel and City Clerk Anna Valencia have been accused of “suborning voter fraud” by allowing Chicago’s CityKey municipal identification card to be used to register to vote. They’ve also been hit with a rival bidder’s politically-explosive claim that printing technology used to create the new ID compromises personal information that the city had promised to keep confidential to shield illegal immigrants from the threat of deportation. (Spielman, 3/26)

Mayor Rahm Emanuel wants Chicagoans to be able to use new municipal ID cards to get discounts on prescription drugs. Emanuel and City Clerk Anna Valencia on Monday announced a request for proposals to add the benefit to the CityKey cards. Chicagoans also will have the option of getting a separate card for prescription drug discounts, the city clerk’s office said. (Schencker, 3/26)

As the owner of the only drugstore in Trimble County, pharmacist Jennifer Grove says she provides a vital service for customers, including some who walk to the Bluegrass Drug Center in Bedford, population 600, to obtain needed medication." A lot of elderly people don't drive," she said. "A lot of poor people don't drive."But the growing power of an industry middleman in the state's Medicaid program known as a "pharmacy benefit manager," or a PBM, to determine payments to pharmacies is threatening the business of the 520 independent pharmacies around Kentucky, according to such pharmacists. (Yetter, 3/26)

They were among a dozen advocates and people living with cancer, HIV, multiple sclerosis and other chronic conditions who met Sunday with Sen. Tina Smith, D-Minn. The group spoke of the challenges of paying for prescription medications and how drug costs can be lowered.In her first piece of stand-alone legislation, Smith has introduced a bill to close a loophole that allows major drug companies to “pay to delay” bringing more affordable generic drugs to market. (Pheifer, 3/25)