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What the Inflation Reduction Act means for PBMs

The Pharmaceutical Care Management Association, which represents PBMs, praised the law for postponing the rebate rule, but once again passed off blame for high drug prices to pharmaceutical companies and health insurers. “The sad reality is that, rather than focus on how to ensure every American can access affordable coverage and high-quality healthcare, the finger pointing is in full swing in Washington with big pharma blaming PBMs and insurers for prices only they can set,” a spokesperson wrote in an email.

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Birth control coverage gaps scrutinized as reproductive health landscape shifts

A spokesperson for the Pharmaceutical Care Management Association, the trade group representing PBMs, said that, while the pharmacy middlemen “almost always” favor the use of generics when substantially equivalent versions to branded drugs exist, they’ll respect attestations from doctors that another contraceptive drug not on the formulary is “medically necessary” and must be covered at no cost to the consumer.

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