ICYMI: JC Scott: PBMs Evolving to Meet Consumer Needs

In a new op-ed published in RealClearHealth, JC Scott, president and CEO of the Pharmaceutical Care Management Association (PCMA), highlights how PBMs are creating new, innovative programs to adapt to changing market conditions to help patients:

"While pharma is lobbying to defend their status quo pricing practices, PBMs are not waiting for government interventions or unnecessary mandates to address what the market is demanding. PBMs have announced several new innovative programs to meet those demands - helping employers and unions offer competitive pharmacy benefits, while giving consumers more convenient access to prescription drugs and lowering their out-of-pocket costs."

Scott outlines specific actions that PBMs are taking to lower out-of-pocket costs, enhance transparency, and work with employers to design prescription drug benefits. He also explains how PBMs are partnering with pharmacies to strengthen the retail market and provide a better pharmacy experience for consumers:

"Innovative programs from PBMs are intended to strengthen access to pharmacies and empower pharmacists to expand the care they deliver to consumers. New, more transparent pharmacy reimbursement models, enhanced pharmacy networks, increased reimbursement in rural areas, and expansion of the clinical services through partnerships with pharmacies will all help evolve the pharmacy market and move toward a more patient-centered future."

He further emphasizes that both consumers and PBMs want lower list prices for prescription drugs:

"Lowering out-of-pocket costs requires that we continue to focus on the list prices set by drug manufacturers, which are always the starting point for questions on cost and affordability. That's why PBMs support and are calling for drug manufacturers to lower the list prices on all prescription drugs. Lower list prices means a better starting point for PBM negotiations for discounts to drive lower costs."

Scott concludes by urging policymakers to focus on real solutions that will benefit consumers rather than special interests that seek to undermine PBMs:

"Challenges to patient affordability and access need to be addressed. And the PBM industry is already moving to respond, demonstrating a focus on patients and a market that is innovative and adaptive. It is crucially important that as policymakers consider proposals to intervene in the commercial insurance market with PBM mandates and limitations, they do so with a full understanding of the numerous ways the market continues to change and adapt."

Read the full op-ed HERE.

View PCMA's new PBM Innovation Project to learn more about what PBMs are doing to put patients at the center of the health care system HERE.

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PCMA is the national association representing America's pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 275 million patients.