ALEXANDRIA, Va. (Oct. 20, 2020) — The National Community Pharmacists Association today launched a new campaign, “The Truth,” aimed at countering a big-money propaganda effort by the pharmacy benefit manager lobby to obscure their role in the high cost of drugs and the disappearance of neighborhood pharmacies.
“PBMs are the middlemen responsible for managing prescription drug benefits for the majority of Americans, with the top three of them controlling 76 percent of all prescription drug business,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “They decide what medicines patients can take, where they must get them, and how much they pay. These mega-middlemen have merged with large insurance companies and now play a huge role in our health care system, and they manipulate that very system so they can operate largely behind the scenes and skirt scrutiny. PBMs serve their own corporate interests, not those of patients or taxpayers. But patients and taxpayers have too much at stake to allow them to continue operating with little or no regulation.”
NCPA’s “The Truth” campaign will expose these and other PBM tactics:
- PBM profiteering: Most patients think their physician makes the final decision about which drug is best for them. In reality, PBMs decide which prescription drugs they will cover based largely on the drugs for which they get the highest rebate from manufacturers, rather than focusing on what might be best for a patient’s health care needs. PBMs raise drug costs by almost 30 percent due to the rebates they charge manufacturers to be on their formularies. PBM rebates, at $143 billion in 2019, add nearly 30 cents per dollar to the price consumers pay for prescriptions.
- Patient steering: PBMs prohibit patients from visiting their pharmacy of choice. Some PBMs are owned by or own the pharmacies they mandate or steer patients to use. PBMs determine which pharmacies are in their network and the amount that the pharmacies will be reimbursed for a prescription. It’s an anti-competitive weapon.
- Forcing pharmacies into a loss and ultimately out of business: It doesn’t stop at steering patients to a PBM-affiliated pharmacy. Small business independent pharmacies have little to no negotiating power when contracting with PBMs and routinely must agree to take-it-or-leave-it contracts to be part of a PBM’s pharmacy network in order to keep serving the pharmacy’s patients. Large health insurers have merged with PBMs to form some of the largest corporations in the country. These large corporations have their own pharmacies, giving them the incentive to drive other pharmacies out of business.
"While independent pharmacies have been essential businesses and health care providers, providing patient care throughout the coronavirus pandemic, the PBMs are seeking to protect their business model from reform, fuel their profits, and reward shareholders,” Hoey said. “They’re even launching misinformation campaigns attacking these essential pharmacies, trying to distract from the PBMs’ own impact on rising drug costs and decreased patient access to community pharmacies.
“We’re exposing ‘The Truth’ about PBMs at every level and at every opportunity, sounding the alarm and pushing policymakers to fix the prescription payment model,” Hoey added. “There must be greater transparency into PBMs and strong oversight to protect patients and small business pharmacies from unfair mega-middlemen business practices.”
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.