Posts Tagged: pharmacy benefit managers
Drugs on a shelf for sale at a pharmacy. (Photo: i viewfinder, via Shutterstock)
OPINION: With the rising cost of health care at forefront of nearly every Californian’s mind, lawmakers in Sacramento are rightly considering a range of potential policy proposals to help rein in costs. In 2018, legislators took positive initial steps to regulate some of the egregious business practices of pharmacy benefit managers (PBMs) – little-known middlemen in the health care system who have contributed to rising costs.
The pharmacy area in a Costco store in Folsom, east of Sacramento. (Photo: Cassiohabib, via Shutterstock)
OPINION: The high costs of prescription drugs have rightly prompted concern from Californians and lawmakers looking for ways to bring down costs. Recently, both California and the federal government have taken positive steps to address this concern by increasing transparency. Still, more action is needed to reduce costs to consumers at the prescription counter.
An open bottle of prescription painkillers. (Photo illustration: Leigh A. Williams)
OPINION: One critical step championed by PBMs is requiring electronic prescribing (e-prescribing) of controlled substances in Medicare. E-prescribing of controlled substances helps ensure each prescription is written by a legitimate prescriber and filled by a legitimate pharmacy.
Pharmacy transparency is one of the most vital components of healthcare in this country – sadly, California is severely lagging in this transparency department. In July, the California Senate Health Committee heard Assembly Bill 315 (AB 315) – it passed unanimously with support from both sides of the aisle.
A pharmaceutical worker examines drugs at a dispensary. (Photo: i viewfinder, via Shutterstock)
The PBMs originated in the 1960s to help health plans, self-insured employers and government entities, among others, to negotiate prescription drug prices and efficiently distribute medications. Since then, they have evolved into a money-making industry without regulations, experts say. By one estimate, three major PBM companies had a staggering $270 billion in revenues in 2014.