A multitude of policy analysts and economists have recently spoken out on the value of pharmacy benefit managers (PBMs).
Satya Marar, visiting postgraduate fellow at the Mercatus Center at George Mason University, explains in a CounterPunch op-ed why PBMs are needed to push back against the high list prices that drug companies alone set:
“We’d pay even more if private health plans didn’t pool patients together and collectively bargain on drug prices through intermediary PBMs. Paradoxically, Big Pharma blames PBMs and their aggressive negotiating practices for higher drug prices even though drugs’ list prices are set exclusively by drugmakers.”
A recent op-ed in Inside Sources by policy analyst Jason Reed echoes Marar’s assessment of PBMs and the value they provide to employers and patients across the country:
“PBMs are the little-known heroes of the American health care system. They act as intermediaries to negotiate drug prices with Big Pharma on behalf of consumers. Insurers and employers hire them to obtain the lowest prices available. In other words, they act as a check on Big Pharma’s power to raise prices…
“PBMs are another impossibly cheap feature of the modern world… They negotiate drug prices on behalf of consumers, keeping Big Pharma in check and maximizing healthcare accessibility in exchange for meager profit margins as low as 2 percent (well below the S&P 500 average of 12 percent).”
Dr. Jeremy Nighohossian, senior fellow and economist at the Competitive Enterprise Institute, argues that PBMs “play an integral role in negotiation and sourcing behind the scenes” and warns lawmakers in Washington against interfering with the PBM market that is delivering lower drug costs for Americans:
“One of PBMs’ major objectives is to reduce costs by using formularies and networks, much like Costco does with groceries. The adoption of PBMs by health plans suggests that they are, overall, saving those plans (as well as consumers and taxpayers) money. Congress shouldn’t insert itself into complex and functioning markets.”
Marar similarly cautions against pursuing policies that would undermine the ability of PBMs to negotiate lower drug prices and in turn, raise costs for patients in an Inside Sources op-ed:
“PBM reforms would undermine the ability of PBMs to negotiate lower drug prices, fail to address the fundamental drivers of costs, and further stifle competitive practices that would otherwise increase choice and lower prices… blanket, industrywide restrictions on negotiation practices that benefit patients and health plans would serve vested interests while backfiring on those they’re meant to help.”
Learn more about how PBMs work at the center of health and savings HERE.
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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 289 million patients.