In case you missed it, JC Scott, president and CEO of the Pharmaceutical Care Management Association (PCMA), discusses the encouraging innovation happening in the pharmacy benefit manager (PBM) market and harmful policies being considered by policymakers that could disrupt these developments in a new post on Medium.

Scott describes the mission of PBMs and why the industry is under attack:

“The core mission of PBMs is to ensure that patients have affordable access to the drugs they need, which means driving down costs for the health care system. Because of the savings that PBMs secure for patients and plan sponsors — including employers, labor unions, and health insurers — drug companies who want to be paid more for their products and pharmacies that want to be paid more for their services are funding self-interested attacks on the PBM industry. 

“Pharmacy benefit companies are under attack simply because of the critically important role they play as the only stakeholder dedicated to lowering drug costs.” 

He goes on to pose important questions for lawmakers to consider when discussing misguided proposals that would undermine the role and value of PBMs to secure savings for employers, patients, and families:  

“As policymakers evaluate pending policy proposals, I would encourage them to ask some key questions: 

“First, what are you trying to solve for? If the goal is lower drug prices, promotion of a healthy pharmacy market, and lower out-of-pocket costs for patients, “delinking” does not achieve those goals. Respected economists from the University of Chicago, USC Schaeffer Center, and Jack Kemp Foundation all agree that the policy would only increase costs.

“Second, is the market already moving in the right direction? And would policymaking limit market innovation instead of encouraging it? Yes and yes.”  

Despite what recent one-sided articles and rhetoric pushed by drug companies suggest, PBMs continue to innovate in the marketplace to meet the unique needs of health plan sponsors and patients. In the piece, Scott highlights several areas where we have seen encouraging innovation in the PBM marketplace, including growing competition between PBMs, lowering out-of-pocket costs for patients, addressing access to popular GLP-1 drugs, promoting the use of biosimilars to drive down costs, and improving the overall pharmacy experience for both patients and pharmacists.

Scott concludes by reminding lawmakers about the strength of the current PBM market and calling on them to deliver what patients really need – lower costs and better access:

“The PBM market consistently shows itself to be dynamic, competitive, and ready to adapt to evolving needs from patients and plan sponsors… Policymakers have an opportunity to deliver what patients really need when it comes to prescription drugs — lower costs and better access. By rejecting the bait from self-interested stakeholders that only want to increase their profits, and instead encouraging the market to continue innovating to address these needs and tailoring public policy to promote competition and build on this progress, we can work together to help patients have affordable access to the drugs they need.” 

Read the full Medium post HERE.

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PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 275 million patients.