Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
I am a pharamcist in Clay Center. I see many times a day the things PBM's do that make prices higher for customers. So many things are done that could, (and I believe do) take advantage of the current system to benefit the PBM, at the expense of the employer, taxpayers, and customer. With little or no oversight of the PBM's they control, and dictate all things in the prescription filling/paying process. I have seen requirements of the PBM to dispense a brand name product, that if the customer would not use his insurance, and generic product would have been less out of pocket for him/her. There was a report that over 40% of PBM revenues were from manufacturer rebates. It is no secret this only serves to increase prices for brand name products for everyone. I have seen copays adjudicated by the PBM for the customer, that the customer pays, then the PBM takes back all but 20 cents of that copay for themselves, leaving us, the pharmacy with a loss. This will eventually lead to less access for the customer. I believe this is totally a deceptive practice. The proposed purchase by one PBM/Pharmacy of a health insurer, I think, can only bring higher prices and restricted access. My daughter had insurance with a drug rider from this PBM. I could not fill her prescriptions, because they required the medication to be filled at there "Owned" pharmacy. There were none of those pharmacies in this area. Her prescription insurance, was essentially useless. I find it unfathomable, the power and lattitude the PBM's have been given over our drug distribution system. I find it equally difficult to find the words describe the frustration the patients, doctors, and pharmacist have with these behemoths. So much effort is put by us, in things that really are there to benefit the PBM and little if any benefit to the patient and their health. I can only believe that a good place to start to lower medication cost in the UNited States is limit, and have some kind of oversight of the PBM industry. It is interesting, that for many years the "cry" has been about the high medication costs in the UNited States. After so much control has been given to the PBM's for the majority of the prescription volume, over the last years, the cry is louder than ever about high prescription costs. So much for tthem controlling costs. Sincerely, Jeffrey Mayo R.Ph.