May 8, 2017
Dear Drug Topics:
Any effort that takes aim at the culprits in drug price rises (Drug Chains, ASHP Support Anti-Price Gouging Campaign, Drug Topics) must include an examination of the role pharmacy benefit managers (PBMs) play. These once-hidden middlemen are being forced out of the shadows, as journalists, lawmakers and the public become more familiar with the rebates, spread pricing and administrative fees that PBMs use to fill their coffers and contribute to higher drug prices. The National Community Pharmacists Association recently produced a booklet and video (The PBM Story) to help educate a wider audience about these tactics.
A step toward reining in PBMs and drug price increases would be to enact pro-patient, pro-pharmacy legislation that would end the retroactive pharmacy direct and indirect remuneration (DIR) fees that push Medicare patients more quickly into the Part D coverage "donut hole"; expand pharmacy choice for Medicare beneficiaries seeking discounted copays in preferred plans; create more transparency for generic prescription drug pricing and reimbursement in federal health programs; and enable pharmacists to more fully utilize their education, training, and expertise in areas where there are primary care physician shortages.
“Follow the money” can be good advice when trying to solve a crime. A good chunk of change is going to PBMs.
B. Douglas Hoey, RPh, MBA
Chief Executive Officer
National Community Pharmacists Association