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The Dose

Another Reporter Turns Up the Heat on PBMS

by John Norton | Mar 17, 2017

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The success of pharmacy benefit managers (PBMs) comes from floating below the public's radar and framing a narrative about how much money they supposedly save the system. Independent community pharmacies' strategic efforts to rein in these drug middlemen occasionally get a welcome boost from investigative journalism.

If I were to create a Mount Rushmore of reporters who pull back the curtain on PBMs' questionable business practices, I would start with Katherine Eban of Fortune Magazine and Lee Zurik of Fox 8 News in New Orleans. A new face belongs on that mountain. During the past few months, the Dayton Daily News' Katie Wedell has written a series of articles about rising prescription drug prices, often with a focus on the role PBMs play in exacerbating the problem.

For example, Wedell's "A video guide: How do prescription drug prices get set?" offers viewers an easy-to-follow, animated explanation of the current system for dispensing and reimbursing prescription drugs. Wedell followed up with an article, "Who's really controlling your drug prices? 5 things to know," which methodically lays out the various ways in which PBMs increase drug prices.

In another article, "Consumer beware: Drug discounts may contain catch," she argues that while drug discounts may provide relief to the patient, those costs are shifted to health plan sponsors and mask all the factors contributing to those high costs, like drug manufacturer rebates to PBMs. In the end, the discount relief is temporary because patients eventually pay more for those expensive drugs through higher premiums and deductibles. There are other articles from Wedell that are well worth reading, which can be found by doing a Google search with her name with key words like prescription drug and/or PBMs.

The Ohio Pharmacists Association aided Wedell in her efforts, especially its director of government & public affairs, Antonio Ciaccia, who was quoted in several articles. Other state pharmacy groups and independent community pharmacy owners should reach out to their local media. Whether it is through a phone call or email, make your pitch to the reporter. Invite them out to a pharmacy visit. See if some of your patients would also be willing to be interviewed about the rising cost of their prescription drugs.

If you need additional materials or advice, please feel free to reach out to the staff at the National Community Pharmacists Association. I am certainly willing to help. You can reach me by email at john.norton@ncpanet.org or 703-600-1174.

PBMs are nervous. The President and CEO of their trade association—Pharmaceutical Care Management Association (PCMA)—recently sent a purported internal memorandum about its multi-pronged strategy to push back against efforts to make PBMs more accountable and transparent. This can be partially attributed to drug manufacturers looking to shift some of the blame for high prices onto the drug middlemen. But reporting from people like Wedell helps to educate the public and lawmakers about PBMs, which are desperate to halt any momentum to end the under-the-radar status quo they have worked so hard to protect.