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Today's Vitals is 953 words, < 4-minute read.
Illustration: Rebecca Zisser/Axios
Express Scripts, which manages pharmacy benefits for roughly 100 million people, claws back millions of dollars per year from pharmacies, according to a contract obtained by Axios’ Bob Herman.
Why it matters: Express Scripts says it passes all of these pharmacy fees back to its clients, rather than hanging on to them as profit.
How it works: The contract Bob obtained applies to Express Scripts' Medicare plans and the pharmacies that participate in its network.
The other side: Express Scripts said in a statement to Axios that "high-performing pharmacies can and do earn more money."
Flashback: Loyal readers may remember that this is the second time Bob has gotten ahold of an Express Scripts contract. You can read his previous series here.
Want to read the contract? Email email@example.com. (And of course, feel free to drop him a line if you have more information to share.)
Photo: Phil Roeder/Getty Images
It's going to be a long day today for the Senate Finance Committee, and after that, a long September.
Driving the news: Finance members have filed 110 amendments for today’s drug-pricing markup. They run the gamut from requesting government reports to making technical changes to new, major, controversial policy ideas.
What's next: Surprise medical billing will join drug prices on Congress’ fall schedule. When it rains, it pours.
Photo: Photo by Drew Angerer/Getty Images
Anthem posted better-than-expected earnings and raised its profit expectations for the rest of 2019, so Wall Street responded by … selling off the stock, dropping Anthem’s share price by 4.5%.
What gives? Investors are freaking out, Bob writes, because the big health insurance companies — UnitedHealth Group, Centene and now Anthem — have indicated their medical costs are rising faster than projected.
By the numbers: One of the most highly watched metrics for insurers is the medical loss ratio, which shows how much of members' premiums are going toward paying medical claims.
Anthem argued that health care expenses aren’t rising wildly, but instead states are not paying high enough Medicaid rates to their plans.
The bottom line: Wall Street's latest sell-off is yet again obscuring the financial and political power insurers enjoy.
This dermatologist is French, but all the other photo options for "dermatology" are of deeply upsetting skin conditions, so we're going with this one. Photo: Fred Tanneau/AFP/Getty Images
Private equity firms are snapping up dermatology practices, and at least some health care experts are not thrilled about it.
By the numbers: More than 700 dermatology practices are now owned by private equity. The number of takeovers increased 12-fold from 2012 to 2017.
What they’re saying: That rapid pace raises a lot of questions about what will happen under private equity firms’ quest for rapid growth, and the consequences once they sell, former deputy FDA commissioner Joshua Sharfstein writes in a JAMA Dermatology editorial.
Between the lines: It’s not just dermatology. Private equity firms have big health care appetites generally.
A handful of drug companies with big vaccine portfolios are especially well-positioned to capitalize on the effects of climate change, according to a Morgan Stanley investors’ note.
The big picture: As I wrote earlier this year, climate change will be a business opportunity for some pharmaceutical companies.
The bottom line: Vaccine development is hard and expensive, so companies that are already in that business will have an upper hand, Morgan Stanley’s analysts wrote.