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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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How self-pay pharmacies can save customers hundreds of dollars a month

“Our job is to drive down costs on behalf of the consumer and those paying the bill for health insurance,” said JC Scott, president of the Pharmaceutical Care Management Association, the trade group that represents pharmacy benefit managers (PBMs). “Without us, there’s nothing standing between the consumer and the … drivers of high drug costs. I’m confident that once the FTC digs in and understands that, they’ll reach that same conclusion.”

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