AJPB July 2019

Costs remain the top concern of healthcare purchasers of pharmacy benefits, but employers are also concerned with ensuring appropriate use of medication and adherence to medication, according to a new report from the Pharmacy Benefit Management Institute (PBMI).

With discussion and debate happening for months in Washington, DC, over drug pricing and the role of pharmacy benefit managers (PBMs), the Institute for Clinical and Economic Review (ICER) published a white paper this week that analyzes 3 possible alternatives to the pharmaceutical rebate system fostered by PBMs.

Several efforts are underway nearly a year after the Trump administration released its blueprint to lower drug prices in May 2018, but tracking their outcomes depends on what metric is used to define drug prices, according to a session at the Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy Annual Meeting, held March 25-28 in San Diego, California.

A policy from the Trump administration to benefit patients and alleviate the high cost of prescription drugs would eliminate rebates from pharmaceutical companies to pharmacy benefit managers.

Prescription benefits consultant Chris Robbins, chief executive of cer of Arxcel, describes the finger-pointing in Congress over lowering drug costs this way: “If it weren’t so true, it might be almost humorous.”

A day after stakeholders told a House of Representatives subcommittee about problems accessing and paying for insulin, Cigna and its pharmacy benefit manager Express Scripts said they are launching a program for patients with diabetes in their commercial plans so that they pay no more than $25 for a 30-day supply of insulin.