Summary
- Consolidation among pharmacy benefit managers (PBMs) is allowing the companies to profit at the expense of patients and independent pharmacists.
- The Federal Trade Commission (FTC) has found that giant PBMs exercise significant control over drug availability and pricing, negatively impacting consumers.
- Lawmakers are under pressure to take action against PBMs amid concerns of market dominance and exploitation.
- The top three PBMs managed 94% of US drug claims in 2023, raising questions about competition and pricing practices.
- Advocates are calling for more transparency, legislation to incentivize lower drug prices, and potential breakup of the big PBMs to promote true competition and consumer protection.
Consolidation among pharmacy benefit managers (PBMs) is on the rise, and it’s causing some concerns. A recent report from the Federal Trade Commission (FTC) shows that big PBMs are making profits at the expense of patients and independent pharmacists.
These PBMs act as middlemen between health insurers and pharmacies, managing prescription drug benefits. The report found that the top six PBMs control a majority of US drug claims, with three big companies dominating the market.
Physicians and consumers are worried about how these PBMs are using their power to control drug availability and prices, ultimately affecting patients. For example, PBMs may steer patients towards more expensive drugs, even when cheaper options are available.
Madelaine A. Feldman, an expert on PBMs, believes that lawmakers should push for more transparency and regulations to prevent PBMs from choosing higher-priced drugs for their formularies. She also highlights the harm that PBMs can cause patients by prioritizing profits over patient care.
Overall, the FTC report raises concerns about the impact of PBMs on patients and pharmacies. Lawmakers and regulators are being urged to take action to ensure fair competition and protect the interests of patients and independent pharmacists.
Public Health & Prevention, Pharmacists, Internal Medicine