AMAC Members Drive Victory for PBM Transparency

midterm capitol members PBM victoryAMAC members have delivered again, and in a very meaningful way on a significant issue. Back in March of this year, the AMAC membership at-large was asked to participate in a call-to-action to leave their comments on a Federal Trade Commission (FTC) website regarding how pharmacy benefit manager (PBM) business practices negatively impact the cost of prescription drugs as well as the dispensing of medications. The FTC was seeking comments from physicians, pharmacists, clinicians, and patients to determine if regulatory oversight is warranted for the outpatient prescription drug supply chain that is dominated by PBMs.

The FTC extended the commenting period through the third week of May and by the time comments were closed, AMAC members ensured the voice of the patient was heard loud and clear by leaving 17,245 of the 24,099 total comments posted to the website.

The significance of this level of engagement by AMAC members cannot be understated. As a direct result of the efforts by the membership and others, the FTC announced in a statement earlier this week that “it will launch an inquiry into the prescription drug middleman industry, requiring the six largest pharmacy benefit managers to provide information and records regarding their business practices. As part of this inquiry, the FTC will send compulsory orders to CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc.; Prime Therapeutics LLC; and MedImpact Healthcare Systems, Inc.”

FTC Chair Lina Kahn said, “Although many people have never heard of pharmacy benefit managers, these powerful middlemen have enormous influence over the U.S. prescription drug system. This study will shine a light on these companies’ practices and their impact on pharmacies, payers, doctors, and patients.”

AMAC Action Senior Vice President Andy Mangione said, “We have been involved in the effort to gain transparency for PBM transactions for years and have maintained that examining these anticompetitive business practices should lead to lower drug costs for all Americans, including those on Medicare. We look forward to monitoring the progress of the FTC’s inquiry.”

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Bert Hodge
6 days ago

Good article.

1 month ago

One thing we must not forget nor let off the hook is that health insurance companies are the buyers of PBM management services. They have a significant role in this. I am afraid that only the downstream issues are being looked at and not upstream back to the insurance companies and even back to the employers and other providers as they determine what the insurance plan will and will not cover by what they purchase. However, the insurance company does design the plans that they will sell. We often complain about the insurance company saying “no” and not realizing that the insurance companies are only enforcing what the plan that was purchased.

Chris Foster
1 month ago

Good work by AMAC members!

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