Pharmacy Benefit Managers (PBMs), the middleman between your insurance company and your pharmacy are being exposed as making billions of dollars each year while your prescription costs rise. Never heard of them? Read on for more information
You may wonder why your prescriptions are more expensive now than they have been in the past. It may even be understandable that new prescriptions may be more expensive. But a great, lifesaving drug like Harvoni becomes less accessible when it costs $98,000 for a 12 week treatment. What is even more puzzling is when a old drug like an albuterol inhaler, which has been out for 20 years, now costs $100 when it only costs $20 when it came out. The Centers for Medicaid and Medicare Services (CMS), the governmental agency that is responsible for Medicaid and Medicare completed an analysis in January. They concluded that one of the culprits for higher prescription costs is the middleman in the prescription business - the pharmacy benefit manager (PBM). These include CVS Caremark, Express Scripts, and several smaller PBMs.
Never heard of these middlemen? That isn't surprising. They hide behind the pharmacies and the pharmaceutical companies, often finger-pointing at both. However, it soon became widely known that pharmacies weren't making a windfall of money, often losing money on each prescription that comes into the pharmacy. The PBM then pointed solely to the pharmaceutical company. Now this murky world of the PBM's are being exposed. In fact, congress is now investigating their practices and bills have been entered into both the senate and the house to limit their reach, and hopefully lower prescription costs. I would encourage each of you to contact your senators and congressmen and congresswomen to encourage them to support these bills. Please read the article at this website to learn more!