Retail News Breaks Archives
NCPA video, website take aim at PBMs
July 11th, 2012
ALEXANDRIA, Va. – The National Community Pharmacists Association has launched a video and a website that it said shines a light on wasteful practices by pharmacy benefit managers (PBMs) that end up costing patients, employers and other health care stakeholders.
NCPA said Wednesday that the website, WhoRunsMyDrugPlan.com, aims to help health plan sponsors — such as employers, unions and government programs — and policymakers and patients get the most from prescription drug benefits by calling attention to wasteful practices by "giant pharmacy benefit managers (PBMs), who are hired to administer drug plans and negotiate prices for payors but drive up health insurance costs and restrict patient choice."
At the site, visitors can view "The Third Wheel," a video that NCPA said takes a satirical look at how PBMs affect consumers' pharmacy benefits by acting as "prescription middlemen" that position themselves amid the relationship between patients, doctors and pharmacists.
"Too many plan sponsors, policymakers and patients remain unaware of how large pharmacy benefit managers affect their prescription drug benefit and their health care premiums," NCPA chief executive officer B. Douglas Hoey said in a statement. "For too long, the PBM industry has benefitted from a lack of oversight and regulation, which has eroded the value of the prescription drug benefit to consumers. We have seen prescription drug costs rise, insurance premiums and patient co-payments increase, higher PBM profits and diminished patient choice — while reimbursement to pharmacy small-business owners for providing prescription drug services continues to decline. It's fair to ask: Where's the money going?"
According to NCPA, the WhoRunsMyDrugPlan site answers the question "What is a PBM?" and cites cost-inflating practices by PBMs in such areas as pricing, rebates, mail order and patient access to pharmacy services.
In addition, the site provides a "take action" page for patients and health plan sponsors plus a resources page linking to other websites, including those of consumer advocates that have expressed similar concerns about PBMs, NCPA said.
"These new online resources are intended to help enable plan sponsors, policymakers and patients to further examine these issues and to insist on meaningful reforms," Hoey stated. "The outdated drug benefit business model of today should be replaced with health plan designs that are aligned to the interests of payers and patients, while properly utilizing pharmacists to reduce costs and improve health outcomes."
NCPA noted that community pharmacists help rein in medical costs by encouraging the appropriate use of low-cost generic drugs and assisting patients in adhering to their medication regimens. The association said these cost-saving measures have been mitigated by such PBM practices as limiting community pharmacy access and mandatory mail order.