Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
I am a community pharmacist that works in an independent pharmacy setting for the past 5 years. In those years, I have seen, and continue to see, the same trends happen over and over again. Drug prices are increasing, reimbursement for my cost of drugs and services is decreasing (often times BELOW my cost), patient copays are increasing, patient access to medications is shrinking, but somehow the PBMs have record setting profits during this same time period. Do you see what the problem is here? As PBMs are allowed to merge and have their own pharmacies and insurance companies, there is a huge conflict of interest. Every day I have patients bringing in letters from their insurance plans, either stating they MUST use the PBM owned pharmacy, or that they will have reduced copays if they switch to mail order. There are many studies that disprove the myth of mail order offering a cost savings to anyone. Not to mention how do you guarantee a medication's stability when it is sitting in a mailbox for 2 days in Florida in the middle of summer? What about when you misplace a medication, forget it on vacation, a drug interaction, or have a simple question? PBMs are not the helpful, cost-savings third-party administrators they portray. They are industry middlemen profiting at every stage of the prescription drug supply chain from the manufacturers and the dispensers to the plan payers and patient. They are driving up drug prices, promoting the use of certain drugs over others, forcing medical providers to remain silent and costing patients and taxpayers tens of millions of dollars every year. The FTC's mission is to protect consumers and prevent anticompetitive business practices. On behalf of patients, drug plan sponsors and small business pharmacies who depend on trusting relationships with their patients, please intervene in these unregulated entities and break up the enormous power PBMs have over the out-of-control cost of healthcare.