New York Times reporting puts the heat on PBM practices

Pharmacy groups in the U.S. have powerful new ammunition in their ongoing fight against the practices of large pharmacy benefits managers. For almost a decade, organizations such as the National Community Pharmacists Association (NCPA, which represents independent pharmacy owners) and the National Association of Chain Drug Stores (NACDS) have spent millions on campaigns to convince the U.S. government to examine and rein in the practices of pharmacy benefits managers (PBMs). The pharmacy groups argue that—as profit-focused “middlemen” who often also operate some of the nation’s largest pharmacy banners and mail order pharmacies—PBMs have caused a dramatic rise in drug costs to patients and drug plans while at the same time siphoning away profits and from pharmacies, leading to thousands of pharmacy closures in recent years. The cause for optimism is a deep dive on the practices of PBMs by journalists from the New York Times that brings the issue to national attention. After a months-long investigative report, on June 21 the Times published the first of what it says will be a series of article on the topic. For ‘The opaque industry secretly inflating prices for prescription drugs,’ reporters interviewed hundreds of insiders, including current and former employees of the PBM industry, pharmacy leaders, pharmacists and pharmacy owners, patients, physicians and employers and found that: “The job of the P.B.M.s is to reduce drug costs. Instead, they frequently do the opposite. They steer patients toward pricier drugs, charge steep markups on what would otherwise be inexpensive medicines and extract billions of dollars in hidden fees, a New York Times investigation found.”As for their impact on community pharmacies: “The P.B.M.s, which are responsible for paying pharmacies on behalf of employers, are driving independent drugstores out of business by not paying them enough to cover their costs. Small pharmacies have little choice but to accept these lowball rates because the largest P.B.M.s control an overwhelming majority of prescriptions. The disappearance of local pharmacies limits health care access for poorer communities but ultimately enriches the P.B.M.s’ parent companies, which own drugstores or mail-order pharmacies.”Read: CPhA files abuse of dominance complaint with Competition Bureau against ESC’s new service feeFuel for pharmacy groups’ fightNCPA CEO Douglas Hoey applauded the article, saying it comes at a critical time in the association’s years’ long campaign against PBMs, a final push to educate and recruit patients in the fight against PBM policies.At the NACDS, president and CEO Steven C. Anderson also celebrating the timing of the report, which appears on the heels of a new awareness campaign stressing the urgency of government action against PBMs. "It's time for Congress to reduce patients' drug costs, to stop PBMs from forcing pharmacies to fill prescriptions at a loss, and to ensure Americans can access the pharmacies and medications that are right for them—rather than those that are right for PBMs' profits," he said in a release from his organization. While PBMs do not yet have the same dramatic impact in Canada as they have had in the U.S., Canadian pharmacy leaders are closely watching as their counterparts put tremendous effort and resources into fighting the industry. Preferred provider networks have re-emerged as a cost-containment measure for some Canadian PBMs, raising alarms with some.At the Neighbourhood Pharmacy Association of Canada's Expo in Halifax on June 25, CEO Sandra Hanna noted in a Town Hall presentation that the association has proactively developed a key position on the threats presented by PBMs.Read: Mark Cuban rips PBMs apart in White House listening session on 'drug middlemen’

New York Times reporting puts the heat on PBM practices

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