FTC to air grievances with PBMs’ abusive practices

The Federal Trade Commission will host an open meeting this morning, and fortunately, drug middlemen are on the agenda. The meeting will review the findings of the FTC’s new interim report on pharmacy benefit managers (PBMs) and how they grow their profits at the expense of patients, employers, community pharmacists, and taxpayers.

Why it matters: The meeting provides a public forum to further expose the many ways middlemen are abusing the health care system, adding more momentum behind efforts to pass strong, bipartisan PBM reform this year.

Quick recap: The FTC’s two-year investigation found that “PBMs wield enormous power over patients’ ability to access and afford their prescription drugs.” Here’s what that looks like in the real world, according to the FTC’s report:

• The PBM industry is “highly concentrated” and part of “complex vertically integrated health care conglomerates,” which gives them “significant power over the pharmaceutical supply chain.”
• PBMs make critical decisions about how patients access and pay for medicines, “without transparency or accountability to the public.”
• PBMs steer patients to pharmacies and businesses that PBMs are affiliated with, which can “disadvantage unaffiliated pharmacies and increase prescription drug costs.”

Flashback: The findings of the FTC’s investigation reaffirm what we at BIO have been uncovering for years: PBMs make it harder for patients to access and afford their medicines. As we’ve reported before:

• PBMs deny coverage of some medicines because it keeps their profits higher.
• Even when the net price of medicines go down, PBMs and insurers make patients pay more.
• PBMs and insurance companies pocket massive rebates that lower the price of medicines, but those savings don’t always go to patients.

BIO’s view: We will be closely following today’s open meeting. And when it’s over, Congress needs to renew the fight against PBM abuses and pass strong reform before the end of the year. It’s clear what the problems are. It’s time to provide patients with meaningful solutions.