ICYMI: Oregon PBM audit confirms need for reforms

NCPA August 22, 2023

The Oregon State Pharmacy Association and NCPA echo the Oregon Health Authority’s recommendation, released Monday as part of an audit report, that the state “should enact legislation that focuses on patient and pharmacy protections and increasing transparency in the prescription drug supply chain.” Among other findings, the audit confirms that Oregon’s regulation of PBMs is limited and fragmented; that while the Oregon Medicaid program has improved some of the coordinated care organizations’ contract language, the agency does not ensure sufficient transparency and compliance by PBMs; and that pharmacy reimbursements were inconsistent and varied greatly depending on the pharmacy, drug, and PBM. It specifically found that national chains, some of which are owned by PBMs or PBM parent companies, were reimbursed twice the amount independent pharmacies were for selected drugs. Read NCPA’s press release about it and stay tuned to qAM for more as the audit’s recommendations begin to circulate.