Pharmacy benefit managers inflate the costs and limit the supply of prescription drugs, writes Brian Higgins.
In this June 15, 2018 photo, pharmaceuticals are seen in North Andover, Mass.Reducing the cost of prescription drugs while protecting access to the medicines patients need is one of the most important issues facing our nation. It remains such an intractable challenge because policymakers have not focused on all the many players who have a role in drug pricing – most notably insurance companies pharmacy benefit managers .
One of the core functions PBMs play is to negotiate significant rebates from the makers of prescription drugs so that insurance companies can pay lower prices. However, those rebates are not required to be passed along to consumers. It’s easy to see why this could be a huge cash windfall for big companies that pocket the savings instead of sharing it.
When costs are needlessly high, and patients find medicines unaffordable, they will often try to reduce the drug’s dosage or the frequency just to make it last longer and delay the need for a refill. This is dangerous for patients in general, but as anyone with mental health issues, or their families and caregivers, know all too well, it’s particularly a problem in mental health treatment.
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