Role of Pharmacy Benefit Managers Under Congressional Scrutiny
November 29, 2021
The role of pharmacy benefit managers (PBM) on patient out of pocket prices was examined by a US congressional hearing that began on November 17th. According to Brian Newell of PhRMA, PBMs negotiate rebates and discounts with drug companies to help patients pay less for medication than the list price set by manufacturers. However, most of the savings go to PBMs and payers, not patients. Passing savings to customers may alleviate this problem, but this was not addressed in the drug pricing bill passed by the House of Representatives.
Newell states, “Patients with deductibles often pay based on the undiscounted list price of a medicine while their health plans can pay nothing and still receive a rebate. In fact, half of commercially insured patients’ out-of-pocket spending is based on the full list price.”
Read the article in its entirety here.
(Source: PhRMA, November 23rd, 2021)