Dear Mr. Cuban (may I call you Mark?),
I read this week that you are starting a PBM. I read this with interest because we have much in common.
You like basketball. I like basketball (I don’t own an NBA team, though.)
You’re a dad with three kids. I’m a dad with three kids.
You hate PBMs. I hate PBMs.
You are a multi-billionaire. Um … well, there are some things we don’t have in common.
But, as I was saying, we do have several things in common, including thinking that prescription drugs cost too much and middlemen PBMs are the main reason why. I’m sure you are aware that the U.S. pays the highest prescription drug prices in the world, but you may not know that the U.S. is also the only country in the world that has handed over the management of prescription drugs to PBMs, and they have had a field day with increasing prescription costs. The higher the better for their profits.
From 1987 to 2019, prescription drug prices increased 10 times faster than the rate of inflation. In the mid-‘80s, PBMs began to migrate from claims processors to mail order pharmacies. They embedded themselves into the flow of every prescription drug transaction from the pharmaceutical manufacturers’ corporate headquarters to the consumer’s kitchen table where they linger as uninvited guests who won’t leave. Here’s NCPA’s PBM Storybook. It highlights the abuses you no doubt have discovered about these interlopers. You’ll like it (if you haven’t already read it).
NCPA’s priority continues to be Changing the Pharmacy Payment Model so that’s something else we seem to have in common. NCPA supports a “cost plus-plus” model for maximum transparency: the cost of the drug plus a professional dispensing fee plus rewards for patient care services that result in improved patient outcomes. There are a number of state Medicaid programs that got tired of the PBM chicanery that costs taxpayers hundreds of millions of dollars and moved to NADAC + a professional dispensing fee commensurate with the cost of dispensing a prescription. NCPA agrees that’s a far better approach than the “trust but no, you may not verify” approach of the PBMs.
One thing we don’t have in common is that it appears you want to build yet another mail order pharmacy that sends lifesaving prescriptions to mailbox hell. Watch this NBC News report from last year. From CNET.com: “Delivery lags could even be a matter of life and death for some people who depend on a mail-order medication system. Already during the pandemic, many people opting to receive prescriptions at home have faced problems receiving their life-saving medicine on time through the Postal Service.”
Why subject a consumer/patient to a wait by the mailbox when there are nearly 20,000 pharmacy small businesses who can do the job oh-so-much better? Plus, as far as I know, when it comes to COVID-19, flu, shingles, and other immunizations, a mailbox hasn’t given one patient a shot! Channel your inner “Shark Tank” shark and say, “I’m out” to mail order.
Mark, join us in changing the pharmacy payment model to one that is straightforward and offers the best care for consumers at the best value.
Sincerely,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
