A Six-Step Solution to the PBM Problem
Health Affairs Blog, Aug. 30, 2018
3 Pages Posted: 12 Oct 2018
Date Written: August 30, 2018
In the past year, pharmacy benefit managers (PBMs) have catapulted into public attention. While PBMs initially helped patients by reducing burdens and lowering price, today they are doing the opposite.
This short piece outlines 6 steps that could address the PBM problem. Congress can take four:
(1) ban gag clauses;
(2) require the disclosure of rebates and other financial benefits;
(3) prohibit retroactive fees charged to pharmacies; and
(4) address conflicts of interest between PBMs and pharmacies.
The government agencies can take the other two:
(5) robust merger enforcement; and
(6) a 6(b) FTC study.
Keywords: PBM, pharmacy benefit manager, drug pricing, rebates
JEL Classification: I18, K21, L40, L41, L43, L65, O34, O38
Suggested Citation: Suggested Citation