Big Pharma continues to misconstrue the critical role and value that pharmacy benefit managers (PBMs) play in the prescription drug supply chain to drive down costs. PBMs are the one real counterbalance to drug companies and their otherwise limitless pricing power to set and raise the price of prescription drugs.
As drug companies continue to push Congress to pass legislation that interferes with the private market by undermining PBMs to boost their own profits, PBMs continue to do their part to lower prescription drug costs and deliver real savings and value for patients and families.
But when it comes to the facts, don’t just take our word for it—look at what leading economists and academics have to say:
Dr. Rena Conti, health care economist and associate professor at the Boston University Questrom School of Business, testified during a U.S. House Committee on Oversight and Reform hearing that PBMs encourage patients to take up more affordable prescriptions:
“PBMs steer patients to use, in general, the cheapest and most effective drug for them. That includes over a 90 percent utilization of generics and biosimilars when they are available. This benefits patients and it benefits their health. Formularies push patients to use low-cost, safe and effective drugs, largely generic and biosimilars when they’re available; that reduces costs for us all and also expands access.
Drug prices are set high in the United States because, simply, drug manufacturers can charge them, and we will pay them.”
View Dr. Conti’s testimony HERE.
Dr. Anthony LoSasso, Professor and Chair of the Department of Economics at DePaul University, shares during the U.S. House Committee on the Judiciary Subcommittee on the Administrative State, Regulatory Reform and Antitrust hearing the importance of PBMs and PBM-secured rebates:
“At heart, what PBMs do is force pharmaceutical companies to compete on price. And competing on price, generally speaking, is the last thing that pharmaceutical companies want to do. I find it somewhat amazing that rebates have been made into some sort of nefarious practice. This to me is testimony to apparently a reality distortion that the pharmaceutical industry is capable of pulling off. Rebates are a good thing because they represent price decreases. And price competition is a good thing for consumers…
So the effort to regulate, and I fear neuter, the impact of PBMs only plays into the hands of the pharmaceutical industry and strengthens their bargaining.”
Dr. Joey Mattingly, Vice Chair of Research at the University of Utah College of Pharmacy, raises an essential question about efforts to dismantle PBMs during a U.S. House Committee on the Judiciary Subcommittee on the Administrative State, Regulatory Reform and Antitrust hearing:
“If you remove the PBM from the equation today, who or what steps in to fill that void?… PBMs typically gain customers from a process where they respond to competitive bids, requests for proposals from plan sponsors and employers and governments who are requesting for help developing formularies, managing a pharmacy network. So when we remove the PBM, we just have to know, okay, then what?”
View the testimonies of Dr. LoSasso and Dr. Mattingly HERE.
Dr. Lawton Robert Burns, Professor at the University of Pennsylvania Wharton School, reinforces the competitive nature of the PBM marketplace:
“PBMs get drug makers to compete on price and get pharmacies to reduce their fees. PBMs also compete with one another in terms of claim processing fees and a host of client services to get contracts with insurers and employers. They are, thus, pro-competitive… In sum, PBMs promote competition in health care and help to reduce prices.”
Read Dr. Burns’ full op-ed in The Hill HERE.
Dr. Dennis Carlton, David McDaniel Keller Professor of Economics Emeritus at the University of Chicago Booth School of Business, affirms that PBMs deliver real savings:
“PBMs play an important role in reducing prescription drug costs for their plan sponsor clients by negotiating prices with drug manufacturers and pharmacies and providing services that facilitate plan sponsors’ efforts to design drug benefit programs that encourage members and prescribers to choose low-cost treatment options that accord with plan sponsors’ health objectives for their members… PBMs lower drug costs for plan sponsors and their members.”
Read his full analysis on PBMs HERE.
The evidence is clear and academics across the country agree: PBMs work to reduce prescription drug costs and promote competition, while Big Pharma pushes for policies that pad their profits at the expense of American taxpayers and patients.
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PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 275 million patients.
