In the world of healthcare, pharmacy benefit managers are no better than the playground bullies that try to take your lunch money.
Forced mail order is a perfect example. Recently PUTT has begun receiving copies of "choice requirement" emails and mailings from our members that read like a low budget suspense novel. Patient walks into their pharmacy to fill their long-term prescription, days later they receive notice from their insurance carrier's PBM that they will be required to pay the full price of the medication going forward if they don't transfer the prescription to mail order service. (cue the scary music)
Privacy rights notwithstanding, steering tactics like this one create a horrible situation where entire families and communities pay the price. It's a prime example of how PBMs care only about their bottom line, not the patients, and certainly not that patient's community. Never mind that this patient may require special assistance from their local pharmacist who knows their medical history & watches for drug interactions between their medications. Never mind that mail order medication is usually shipped to the patient from a distance and can easily be rendered ineffective in treating that patient's condition due to a lack of temperature control during transit, which could cause them to become far sicker than before. Never mind that the required 90 day supply of medication that mail order plans force to be ordered could potentially result in extra medications ending up in the wrong hands and on the wrong side of the law. Never mind that the patient's local pharmacy is the go to hub for healthcare in that particular community and that by forcing patients to use mail order instead of filling their prescriptions locally, that pharmacy could ultimately be forced to close its doors. The list of detrimental outcomes is long and ominous.
Job losses, destruction of local business, patient safety issues, illegal drug trafficking, and spoiled medication possibilities swirl like a rip tide effect around these PBM forced "choice requirements". Georgia got it right with their recent anti-steering legislation this past session, but how many more community pharmacies will fall to these over-sized healthcare bullies in other states before legislation is passed to stop the fleecing? How many more patients will become sicker - or worse - from improperly stored medication during transit? How many more prescription drugs will hit the streets due to forced ordering excess? It's time to stop the madness and bring these healthcare bullies to justice. Without PBM regulation, America's prescription drug system is doomed to continue into a downward spiral of monopoly, oligarchy, disease, and patient despair. We all deserve better.