PhRMA’s Post

Hats off to NYT reporters Reed Abelson and Rebecca Robbins for uncovering the hidden truths about prescription drug costs. Thanks to their investigation, millions of Americans will gain a clearer view of the opaque practices of PBMs, shedding light on how these impact healthcare affordability. It's clear that the current system often prioritizes profits over patient needs. As SmithRx SVP of Product Strategy Alan Pannier notes, 'Evaluating PBMs through a cost-based lens is the only way to expose the problem. Employers should stop thinking of healthcare payments as a ‘tax’ and look at their per member per month spend (pmpm).' Stay tuned this week for a further analysis of how these revelations affect your healthcare decisions. It’s 2024, time to prioritize transparency and affordability. https://lnkd.in/gie2qXjk

In case you missed it 😉 "The job of the P.B.M.s is to reduce drug costs. Instead, they frequently do the opposite." That's from this morning's The New York Times front-page article; it's an incredible read on the #PharmacyBenefitManagement industry based on what appears to be exceptional due diligence. For six years, we've been battling the "status quo" traditional PBM business model's opacity and misaligned incentives, which have thrived at the expense of payers and patients despite clear warnings. If you've ever heard A. J. Loiacono, Ryan Kelly, Kristin Begley, PharmD, et al. speak at conferences, on webinars, or at finalist meetings, then you know why we're saying, "Thank you, Rebecca Robbins and Reed Abelson, for highlighting how clear and present many of the issues remain, as well as the real impact they have on America's healthcare consumers." #PharmacyBenefitAdministration #AlignmentMatters #DrugPrices #HealthCareCosts Check out the article here: https://okt.to/5r8Ha2

This deeply reported months-long investigation by the NY Times into prescription drug middlemen known as pharmacy benefit managers (PBMs) is a perfect example of why journalism still matters. We've been fighting PBMs for years, but like many other powerful and corrupt entities, they thrive by flying under the radar - which makes this front-page story so important to fixing our broken health care system. #pbms #pbmreform #healthcare #prescriptiondrugs #fixrx https://lnkd.in/eKyHBe-x

Pharmacy benefit managers are driving up costs for millions of people, employers and the government. But many people don't even realize they exist. Learn how #PBMs are driving up prescription costs for Americans in this article by The New York Times:

The current pharmacy system is broken and a recently published The New York Times article by Rebecca Robbins and Reed Abelson drops the veil on pharmacy benefit managers (PBMs). The investigation found that the largest PBMs often act in their own financial interest at the expense of their clients and patients. At Blue Shield of California we announced our new pharmacy model last year with the goal of changing the broken incentives that currently encourage higher drug prices. We will no longer participate in a pharmacy system that is designed to maximize the profit of participants instead of the quality, convenience, and cost-effectiveness for consumers. #healthcare #pharmacy https://lnkd.in/g6gznUXZ

"For certain types of drugs with complicated handling or administration needs, called “generic-specialty” medications, the company’s health plan on average paid about six times as much on average as the pharmacy benefit manager paid, the complaint alleges." This would never happen with our PBM solution, Drexi. Our contracts are solid and don't wordsmith in a way that is complicated, unclear and detrimental to the employer and its members. When defining a Generic, many PBMs like the one J&J is partnering with use broad language so that situations like this can happen....and they do all of the time - this is not a one-off situation in the slightest. I have a new Drexi case where we saw this same example in the data with their former PBM. The numbers were not as egregious like this example of ~$40 vs. $10K! But it was a $4000 price that should have been ~$100. And it was a "Specialty-Generic". Our PBM can save upwards of 45-50% on pharmacy claims. That is significant! With the huge spikes in costs and the expectation that there is a lot more to come in the future (some stating pharmacy spend will soon surpass medical), we would love to offer a complimentary analysis to show a prospective client how we operate and the significant savings that we can bring - along with a unique and powerful tool for members! https://lnkd.in/gYq42Pw9

Pharmacy Benefits Managers are the eye of the storm when it comes to the debate about tamping down costs for life-saving medications. The New York Times has published an accessible account of the multiple layers of business dealings and the players involved, and exposed the fact that while profits are extreme, there is little value being added. "This is the first article in a series about how pharmacy benefit managers prioritize their interests, often at the expense of patients, employers and taxpayers." I encourage you to read the article and be better informed. https://lnkd.in/gMZcMyEx

"The job of the P.B.M.s is to reduce drug costs. Instead, they frequently do the opposite." That's from this morning's The New York Times front-page article; it's an incredible read on the #PharmacyBenefitManagement industry based on what appears to be exceptional due diligence. For six years, we've been battling the "status quo" traditional PBM business model's opacity and misaligned incentives, which have thrived at the expense of payers and patients despite clear warnings. If you've ever heard A. J. Loiacono, Ryan Kelly, Kristin Begley, PharmD, et al. speak at conferences, on webinars, or at finalist meetings, then you know why we're saying, "Thank you, Rebecca Robbins and Reed Abelson, for highlighting how clear and present many of the issues remain, as well as the real impact they have on America's healthcare consumers." #PharmacyBenefitAdministration #AlignmentMatters #DrugPrices #HealthCareCosts Check out the article here: https://okt.to/8SVeHz

🚨 The Recent NYTimes article on the Opacity of PBMs shows the problems that happen when your healthcare costs are managed in the dark. This is especially true when it comes to CAA compliance. As the truly transparent PBM, AffirmedRx offers peace of mind in a world of regulatory complexities. You can focus on operating your business knowing you've made the right choice. #PeaceOfMind #ComplianceConfidence #AffirmedRx   We have long advocated for transparence in the PBM world. But you don’t have to take our word for it. Read in the NYTimes about how the opaque PBMs are secretly inflating prescription drug prices and your healthcare costs. As a truly transparent PBM, we look at you as a partner, not a profit center. https://lnkd.in/dnesEG9Q

It should not be one of the other. Finanical success or taking care of employees. There is a way to balance and a way to do both so they are aligned to your company's desire to be successful long term.