Drugs, Lies & Transparency: The Fallacy of PBM "Self-Reform"
The PUTT Blog
July 9, 2020
An article in Managed Healthcare Executive reported that over the past few years, PBMs have begun expanding from pharmaceutical management to accepting responsibility for managing healthcare’s overall costs. The article explains PBMs are engaging in ‘self-reform’ in four key ways:
Supporting Physicians and Providers at the Point of Care
According to Prime Therapeutics, “PBMs are working with all parts of the supply chain and with payers and providers to make changes quickly and thoughtfully. All parties are aligned in helping drive the best care in a consumer-focused manner at the most affordable price.”
Our response: If Webster’s Dictionary is seeking examples of doublespeak, this is a ‘prime’ example (so to speak).
PUTT regularly hears from doctors and pharmacists with evidence of the opposite. Patients are denied care, doctors’ orders are overridden by step-therapy requirements - unfulfillable during COVID - and despite executive orders from state governors, PBMs deny medication pre-fills, refills, or refuse to reimburse pharmacies for prescriptions.
These must be examples of “making changes quickly and thoughtfully” and are probably a driver behind surprisingly healthy PBM revenues during a time when everywhere else is experiencing a pandemic-driven economic downturn. One can only assume the PBM definition of “consumer-focused” equals ‘shareholder dividends’.
This July 31st is your opportunity to meet state legislators on the forefront of PBM reform - all from the comfort of your home or office! Our 2020 Digital Political Summit is FREE to PUTT members. Non-member registration fee is $25.
The registration deadline is Thursday, June 30th and space is limited so be sure to lock in your spot fast!
Neighborhood pharmacies struggle to stay open due to PBM restrictions
CBS Tampa Bay
July 9, 2020
As COVID-19 cases skyrocket in Florida, we've talked a lot about what doctors' offices are doing, but what about pharmacies?
Whether you realize it or not, your pharmacy options are becoming more limited but not because of COVID, but from something called Pharmacy Benefit Managers, or PBMs. It's a big enough problem that one Tampa lawmaker is working to pass a bill to protect independent pharmacies and demand transparency.
Noriega's family opened their own pharmacy back in 1956 in Brandon, at a time when the city population was just 2,000 people. Continue Reading