Pharmacists across the U.S. came together to form a coalition to advocate transparency in drug pricing. So far, 600 pharmacists in 40 states have joined Pharmacists United for Truth and Transparency to expose the tactics that pharmacy benefits managers (PBMs) use to drive up drug prices.
PBMs represent a powerful, unregulated industry that controls drug pricing for the more than 200 million U.S. citizens enrolled in healthcare plans. They are go-betweens that negotiate drug prices with manufacturers and claims administrators for private insurers, Medicare, the VA, government insurers, and everyone else on any kind of medical plan. If Express Scripts is allowed to merge with Medco Health Solutions, the resulting PBM would be the largest in the nation. A bipartisan group of Congress members recently sent a letter to the FTC warning that the unregulated merger of the two industry giants would limit access to critical drugs by raising prices and blocking pass-through pricing for both patients and plans. The Congressional committee called for a complete investigation to include potential impact the merger would have on the market and the industry.
The issue at hand
Pharmacists United for Truth and Transparency was created to combat PBM industry propaganda by publishing and publicizing PBM price sheets and claims data. The Pharmaceutical Care Management Association, a trade group funded by PBMs, makes lofty claims of saving consumers trillions of dollars in prescription drug costs. The group contends that these claims are far from the truth, and that the American people would be outraged by the truth. PBM profits have skyrocketed over 400% over the last five years, while prescriptions became much less affordable for many Americans.
“Pharmacists are in a unique position to compare actual prescription drug prices with the amount PBMs charge for the same lifesaving medications,” said Dave Marley, a founding member of Pharmacists United for Truth and Transparency. “Americans will demand swift and serious reforms when they see examples of their outrageous markups.” Pharmacists United for Truth and Transparency aims to protect the benefit plan sponsors and the end consumer from artificially inflated prices.
The movement for transparency is rapidly gaining momentum, with support pouring in from pharmacists, drug wholesalers, buying groups, and similar organizations that focus on PBM issues.
Where do you stand on the transparency issue? Is it a full blown scandal, with the PBMs engaging in tactics worthy of swarthy corporate pirates, or is the issue completely overblown? Do PBMs deserve all the profit the market will bear? If the pharmacist group succeeds in exposing PBM malfeasance, what are the potential ramifications and backlash? What happens next?