Rethinking PBMs for Effective Healthcare Policy Reform
Understanding the Role of PBMs in Healthcare
PBMs, or pharmacy benefit managers, significantly influence healthcare policy reforms. Panelists at the Community Oncology Alliance Payer Exchange Summit highlighted the urgency of reforming PBM practices, specifically addressing spread pricing and the need for direct contracting with pharmaceutical companies. Despite challenges for employers, these discussions signal a shift towards transparency. Prominent representatives, such as Fred Barton and Joseph Shields, stressed that transparency and public benefit should be at the forefront of PBM operations.
Strategies for Reforming PBM Practices
A recent report from the Biosimilars Council indicated that rebate schemes from PBMs have cost patients and payers a staggering $6 billion in reduced biosimilar adoption. Shields, managing director of Transparency-Rx, argued that alignments prioritizing transparency could reduce drug costs by 15% to 20%. Similarly, Barton discussed how AffirmedRx is redefining PBM operations with a public benefit approach, emphasizing simplicity and member value. Mike Stancil, CEO of the Pittsburgh Business Group on Health, further echoed the need for reform, showcasing the potential for innovative PBMs to disrupt traditional models.
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This article was prepared using information from open sources in accordance with the principles of Ethical Policy. The editorial team is not responsible for absolute accuracy, as it relies on data from the sources referenced.