Putting Express Scripts on the Defensive

Putting Express Scripts on the Defensive

As criticism mounts over some of the dirtiest tricks used to boost profits by pharmacy benefit managers (PBMs) – who often price-gouge plan sponsors and drive up prescription drug costs – the nation’s largest and most powerful PBMs are clearly feeling defensive.  That’s understandable considering the squeeze PBMs have put on pharmacists, plan sponsors and consumers by hiding the real costs of prescription drugs and imposing large markups to make huge profits.

After a column in the St. Louis Post-Dispatch and a subsequent letter from Pharmacists United for Truth and Transparency explaining some of the most egregious PBM tactics, Steve Miller, a senior vice president at Express Scripts, penned a shameless piece in response.  Miller espouses the “virtues” of PBMs with arguments based on the same deceptions his industry has used for years.  But, it’s good to know Express Scripts feels threatened enough to respond to our complaints.

Mr. Miller claims that the PBMs’ role in “cutting prescription costs, driving out waste and improving health outcomes never has been more important.”  But he fails to explain why PBMs continue to operate with little transparency for pharmacists and plan sponsors.  Often, PBMs use intentionally vague terminology when billing employers, thereby keeping them unaware as to the real cost of a drug.  And while employers generally assume they’re paying the same amount as what the PBM gives the pharmacy plus a small administrative fee, PBMs are notorious for marking up the drug price and pocketing the difference.

It’s a simple trick, but one that has helped Express Scripts increase profits while plan sponsors and pharmacists are kept in the dark.  Last year, Express Scripts’ CEO collected a salary of more than $50 million according to Forbes.

If Mr. Miller insists that the partnerships between big PBMs and pharmacists are “mutually beneficial,” he’s living in a different world.