Secrecy Shrouds Boards That Wield Immense Power Over Prescription Drug Coverage
Pharmacy benefit managers release a list of drugs they're excluding for coverage for the year, which helps pressure drugmakers into keeping prices affordable. But the people on the board that makes those decisions are undisclosed, and critics are calling for increased transparency.
St. Louis Post-Dispatch:
A Secretive Board Controls Access To Prescription Drugs For Millions Of Americans
Each year, Express Scripts releases a list of prescription drugs it will exclude from coverage for the upcoming year, and that list is determined by a secretive board of doctors and a pharmacist. The nation’s largest pharmacy benefit manager, which is based in St. Louis County, does not disclose the names of the board members or any actual or potential conflicts of interest they may have. Express Scripts is not alone. (Liss, 8/14)
Earlier, related KHN coverage: Filling A Prescription? You Might Be Better Off Paying Cash (Appleby, 6/24)
Will Your Prescription Meds Be Covered Next Year? Better Check!
The battle continues to rage between drug companies that are trying to make as much money as possible and insurers trying to drive down drug prices. And consumers are squarely in the middle. That's because, increasingly, prescription insurers are threatening to kick drugs off their lists of approved medications if the manufacturers won't give them big discounts. (Kodjak, 8/15)