December 11, 2020

Welcome to the Pharmacy Benefit Brief. This brief is your monthly snapshot of news from America’s prescription drug supply chain including pharmacy benefit managers, independent pharmacies, and drug manufacturers.


Tis the Season for Rx Savings…

In the spirit of the holiday season, this month we’re sharing some information about how – and how much – Pharmacy Benefit Managers, PBMs, are working to reduce prescription drug costs for patients, and health care plan sponsors. After all, less money spent on prescriptions, means more holiday gifts for family and friends.

From 2020 to 2029, the current use of PBM tools in the marketplace will save plan sponsors and consumers more than $1 trillion.

You may not be aware, but PBMs are the only member of the prescription drug supply chain lowering drug costs, and now implement prescription drug benefits for some 266 million Americans.

Here’s a breakdown of savings by market segment:

pbm tools savings by health plan segment pie chart

This information is discussed in detail in a recent study by Visante. Read how PBMs achieve these savings in “Pharmacy Benefit Managers (PBMs): Generating Savings for Plan Sponsors and Consumers.

How the Grinch Stole the Savings…

Passing new legislative or regulatory mandates that restrict PBM cost-saving tools will increase prescription drug costs. Remember, PBMs are the only member of the Rx supply chain lowering drug costs. So they have a tough job and need their cost-saving tools. Take a look at a Visante paper, Increased Costs Associated With Proposed State Legislation Impacting PBM Tools, that estimates the potential cost impact of four types of state legislation impacting the tools PBMs use to lower prescription drug costs.

The study models how the savings from those tools would be reduced and how projected drug expenditures might increase over the next 10 years as a result.

Looking ahead to 2021, keep these points in mind when thinking about how to reduce drug costs – and don’t be the Grinch who stole the savings.

Did you Know?

Pharmacy benefit managers, PBMs, are working to address the ongoing opioid crisis, and according to a new piece written by Julie Olson, with Navitus Health Solutions, PBMs are uniquely positioned to connect different parts of the health care system to increase opioid prevention.

Read Julie Olsen’s op-ed in MedCity NewsOpioid overdoses are spiking amid the pandemic – PBMs can help combat opioid abuse and misuse to find out more on how PBMs are helping to improve this public health crisis.

The Latest in Rx News

Florida Representative Charlie Stone is out with a new op-ed on that discussed the value of mail-service pharmacy. It’s worth a read in the Ocala Star-Banner: Mail-order prescriptions are essential for patients