In my experience, PBMs do not contribute to the rising costs of prescription drugs—in fact, they do the exact opposite.

JC Scott and PCMA’s top lobbyist Kristin Bass talk about the criticism facing the PBM industry, how to break through to policymakers and the future of the industry.

“The PBM industry is the only stakeholder in the chain dedicated to seeking lower costs, and we are proud to play that role,” said JC Scott, president and CEO of the Pharmaceutical Care Management Association. “PBMs do that work for the employer, union health plan, and government clients who hire them and most importantly, the patients for whom those plans provide coverage.”

JC Scott, Pharmaceutical Care Management Association, President and CEO Scott worked to include a repeal of the last administration’s prescription-drug rebate rule in the Democrats’ reconciliation package.

“This extra year will help to reduce disruptions to Medicare beneficiaries by allowing Part D plans time to adjust their pay-for-performance pharmacy contracting,” PCMA said. “In addition, the delay appropriately prevents premiums from increasing in 2023 on top of rising inflation.”

“We believe the key to reducing drug costs is increasing competition, including for insulin products,” said the Pharmaceutical Care Management Association (PCMA). “Unfortunately, tactics used by drug manufacturers to avoid competition, including ongoing patent extensions on insulin products, are a significant barrier to getting costs down even further for people with diabetes.”

Drug manufacturers have leveraged limited competition in the insulin market to increase the list price of insulin products over the past 10 years. PBMs, on the other hand, are working on behalf of patients to negotiate lower costs and increase access to these needed medications. PBMs have stepped up efforts to help patients living with diabetes afford their medications by introducing new programs to cap, or outright eliminate, out-of-pocket costs on insulin.

The provision to target rebates drew pushback from the Pharmaceutical Care Management Association, which represents the PBM industry. The priorities would “provide drug manufacturers additional opportunities to maximize revenues by gaming which products to roll back to 2006 prices to avoid discounting, and which products to keep at 2022 pricing,” the group said in a statement to Fierce Healthcare. “It would do little to reduce costs for patients.

Greg Lopes, a spokesman for the Pharmaceutical Care Management Association, said PBMs believe the key to lowering costs for insulin, and drugs more broadly, is more competition among manufacturers. He said drug companies have avoided doing that through tactics like extending patents on insulin products.

“We are simply seeing more activity in the pharmacy space, which is leading to more business,” JC Scott, the head of the Pharmaceutical Care Management Association, the primary lobbying group for PBMs, told STAT. “There’s more demand for PBM services as a result of that.”