Senate Finance Leaders Seek Probe Of Middlemen’s Controversial Pricing In Medicaid Programs
The letter from the senators pointed to instances where the middlemen, - known as Pharmacy Benefit Managers,or PBMs - in the prescription drug supply system have purportedly used a practice called spread pricing to make millions of dollars in excess profits at the expense of state Medicaid programs. Also in the news, a new poll suggests many employers are interesting in rethinking the use of PBMs.
Lawmakers Ask The Trump Administration To Investigate PBM Pricing
As pharmacy benefit managers undergo increasing scrutiny, two lawmakers have asked the Health and Human Services inspector general to investigate so-called spread pricing practices by these pharmaceutical middlemen as part of a larger inquiry into rising drug costs. In an April 8 letter released on Wednesday night, the heads of the Senate Finance Committee pointed to instances where PBMs have purportedly used this practice to make millions of dollars in excess profits at the expense of state Medicaid programs. Spread pricing is a crucial but little-known part of the opaque pharmaceutical pricing system and refers to fees PBMs pay pharmacies and bill back to Medicaid. (Silverman, 4/11)
Many Employers Would Like To Drop Controversial Rebates On Drugs
As Washington lawmakers struggle to find ways to lower drug costs, a new survey finds that a sizable proportion of employers support proposals to eliminate the rebates paid by drug makers to win favorable insurance coverage. Specifically, 42% of nearly 600 employers support eliminating rebates for both public and private payers, and another 5% were in favor of eliminating them only for government healthcare plans. Just 17% opposed any change to the current rebating system, but 36% have no opinion or want more information, according to the survey conducted last month by the Mercer benefits consulting firm. (Silverman, 4/11)