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In a move that exemplifies the potential conflict of interest that some large pharmacy benefit managers have, the nation’s largest PBM earlier this year said it would demand that rebates remain unchanged when drug makers roll out new price cuts.
Drug makers earlier in the year said they would start reducing prices as well as the rebates they pay PBMs to appease lawmakers and the Trump administration, saying it would reduce the cost of medicine for patients.
In 2015, spending on prescription drugs grew 9%, faster than any other category of health care spending, according to the U.S. Centers for Medicare and Medicaid Services.
President Trump has signed two bills into law that would add transparency to drug pricing by banning gag clauses imposed by pharmacy benefit managers (PBMs) that bar pharmacists from discussing drug prices with the person buying prescription medication.
What started out as a way to help many pharmacy benefit managers (PBMs) to control costs has turned into a major sticking point in the health care system: pharmaceutical rebates.
Three in five employers think their contracts with pharmacy benefit managers are overly complex and not transparent, according to a new study.
The study, which found that employers would prefer that PBMs are more transparent with their pricing and would like them to focus less on rebates and value-based designs, comes as PBMs are under increased scrutiny for their opaque pricing practices.
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