New PBM ‘Report’: Not Fit to Print


A document released recently by the Pharmaceutical Care Management Association (PCMA) is a distorted re-hashing of a few, months-old news articles into what it calls a ‘report.’ It calls to mind a cardinal rule of the political campaign season that is now well-underway: when you’re losing a debate, try to change the subject.

In recent years, we have seen prescription drug costs rise, insurance premiums and patient copayments increase, higher PBM profits and diminished patient choice—while reimbursement to pharmacy small business owners for providing prescription drug services continues to decline. The common-sense question that PBMs want to avoid is: Where’s the money going?

The bipartisan pharmacy audit fairness legislation NCPA supports, H.R. 4215, is based on a straightforward principle: When a pharmacist dispenses the right medication to the right patient at the right time, as prescribed by a doctor, it should not be a punishable offense. That’s why more than 20 states have enacted pharmacy audit fairness legislation. These bills allow for audits against true fraud and abuse. What they deter are abusive audit practices that appear intended primarily to generate revenue for the middleman.

Similarly, the PBM lobby’s claims regarding drug shortages and drug diversion issues are highly misleading. The facts on these issues are available here and here, respectively.

For the PBM lobby to criticize independent community pharmacies for what PBMs claim are ‘opaque business practices and pricing strategies’ is the height of hypocrisy, akin to the pot calling the kettle black. PBMs spend vast resources intended to thwart any meaningful regulation and oversight of a secretive business model that has enabled them to mushroom from simple claims administrators to billion-dollar middlemen.

Perhaps most shocking is how the report attacks Members of Congress for supporting their local neighborhood pharmacies. We know that the PBMs have a tin ear when it comes to fair business practices in dealing with pharmacies. We did not know that it extended to dealing with Members of Congress.

1 Response to “New PBM ‘Report’: Not Fit to Print”



  1. 1 Pbms news | Switchtoseeds Trackback on September 13, 2012 at 4:19 am

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