October 8, 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.

Supreme Court Hears Landmark Case on Employer Healthcare Coverage…

A pending decision by the U.S. Supreme Court in Rutledge v. Pharmaceutical Care Management Association could fundamentally alter patients’ health care plans.

The cost of providing health care is already expensive enough for America’s employers. At stake in this case is the significant increase of health care costs by burying employers in red tape and mandating potentially numerous different rules from state to state.

Why should an employer be forced to provide anything but equal health care coverage to its employees from state to state across the country?

Interested in the implications? Take a look at op-eds by Christopher Goff and JC Scott for more details:

“There will not be organized and consistent rules of the road for employee health benefit plans and policies, making it a regulatory landmine for employers. This will create confusion and chaos, and result in decades of complicated, overlapping powers and litigation — with taxpayers footing the bill,” Christopher Goff, CEO and general counsel of Employers Health. “As the health care system and prescription drug supply chain slowly return to pre-pandemic levels where possible — and adjust to a new normal where not — additional regulations and further disruption is the last obstacle employers, taxpayers and patients should be facing,” JC Scott, President and CEO, PCMA.


Trick or Treat? More Big Pharma Shenanigans…

Last month’s Pharmacy Benefit Brief explained why insulin prices can be very high. This month we’re pointing out that it doesn’t stop there. Drug manufacturers set extremely high prices on other prescription drugs, too.

In fact, Congress released new reports this month on drug manufacturers’ pricing practices. Here’s Rep. Carolyn Maloney (D-NY), chair of the House Committee on Oversight and Reform, at a recent hearing on the reports explaining how Big Pharma, alone, is responsible for drug prices:

“The document[s]… show that these massive price increase are based on generating windfall profits for these companies, their shareholders, and their executives,” said Rep. Maloney.

She continued, calling pharma’s claims that PBMs are driving up the prices – “bogus.” There’s more: View Rep. Maloney’s opening remarks.


Did you Know?

PBM Mail-Service Pharmacies will save $59.6 billion over 10 years. PBMs’ top priority remains enabling patients to access prescription drugs safely, conveniently and affordably.

“For those with chronic conditions, older Americans and patients residing in rural, remote and other underserved communities, home delivery service for prescriptions is crucially important to a healthier, higher-quality life,” JC Scott, President and CEO, PCMA.

Listen to the PCMA Podcast, “The Pharmacy Benefit”: How PBM Mail-Service Pharmacies Help Patients


The Latest in Rx News
  1. AstraZenica drastically boosting prices of its drugs while receiving government funding to develop COVID-19 Vaccine
  2. State treasurers urge Gilead to lower the price of remdesivir and not pursue “unreasonable profits”
  3. Rand study: Comparing Insulin Prices in the United States to Other Countries

What is a PBM? Watch the short video here.