ALEXANDRIA, Va. (March 30, 2023) – Independent pharmacists and the patients they serve have long had concerns about pharmacy benefit managers, their anticompetitive practices and the role they play in ever-increasing drug costs, the National Community Pharmacists Association said in a statement for the record that emphasizes the need for accurate reporting and transparency into PBM financials. The statement is for a hearing being held today at 10 a.m. ET by the U.S. Senate Committee on Finance, which will be examining PBMs and their effects on patients and taxpayers. The committee is led by Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho).
“Independent pharmacies are the patient safety net for millions of Americans, but the viability of these essential health care providers is threatened by PBM-insurer practices that make it increasingly difficult for them to keep their doors open,” said Anne Cassity, NCPA senior vice president of government affairs. “It isn’t only pharmacies that are suffering; it’s patients, too, who are steered away from the pharmacies of their choice and forced to pay exorbitant drug costs that pad PBMs’ pockets. We need transparency and we need relief. We’re grateful to Sen. Wyden and the Senate Finance Committee for holding this hearing and continuing the important work of shining a spotlight on PBMs and their anticompetitive practices.”
NCPA’s statement details a number of areas of concern, including PBMs’ complicated and opaque methods of determining pharmacy reimbursement; their methods of steering patients towards PBM-owned or affiliated pharmacies; fees and clawbacks charged to pharmacies; potentially unfair audits of independent pharmacies; the prevalence of prior authorizations and other administrative restrictions; the use of PBM-defined specialty drug lists and associated specialty drug policies; the effect of rebates and fees from drug manufacturers on formulary design and the costs of prescription drugs to payers and patients; and more. It also calls attention to a lawsuit filed earlier this week by Ohio Attorney General Dave Yost, which accuses the PBMs Express Scripts and Prime Therapeutics of colluding with Ascent (a Switzerland-based group purchasing organization) to illegally drive up drug prices which resulted in higher out-of-pocket costs for patients. Additionally, the complaint argues, “PBMs also use their market power to hurt competing pharmacies, and particularly independent pharmacies.”
Click here to access NCPA’s comments to the Senate Finance Committee.
###
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 19,400 pharmacies that employ nearly 240,000 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.
