With pharmacy benefit managers (PBMs) under a cloud of their own making due to a business model wholly dependent upon opaque, non-transparent drug pricing practices, the Centers for Medicare and Medicaid Services (CMS) recently prohibited yet another controversial PBM practice relating to “spread pricing” in state Medicaid.
Without repeating the entire story — and how probable PBM Medicare “spread pricing” also requires scrutiny — a client, the Senior Care Pharmacy Coalition (SCPC), had this piece I wrote (“As CMS Mitigates Medicaid ‘Spread Pricing’ Abuse, Time to Address Medicare Abuses”) published in Morning Consult Health.
As much as I’ve attempted to focus on other aspects of drug pricing and its growing profile in the upcoming 2020 election cycle, PBMs just keep providing more fodder; the proverbial “gift that keeps on giving.”
And to think just three years ago, PBMs were essentially unheard of and invisible. No longer — and consumers and taxpayers are better off.
From a full-disclosure standpoint, PBMs are a constant target of my client, SCPC — and PBMs have their own policy viewpoints represented by the Pharmaceutical Care Management Association (PCMA)