New PhRMA ad exposes yet another way PBMs get between patients and their medicines

PBMs don’t just decide what medicines patients can get and what they pay out of pocket. They can also control what pharmacy patients can use. That’s the theme of a new ad launching today as part of our multi-year effort exposing the ways pharmacy benefit mangers (PBMs) get between patients and their medicines.

After years of aggressive consolidation, just three PBMs control 80% of all prescriptions in the United States. They are each owned by or own some of the nation’s largest health insurance companies. They also own pharmacies, which are becoming a larger share of their profits. They are now increasingly buying up doctors’ offices, too.

As a result, PBMs can steer people toward pharmacies that make them more money, regardless of what’s best or most convenient for patients. This is another example of the abusive tactics that can make it harder for people to get the medicine their doctor prescribed.

This is the fourth installment showing how PBMs make decisions based on what’s best for them, not patients. Previous ads have shown:

• PBMs decide what medicines patients can get and what people pay out of pocket
• PBMs, insurers and other entities are taking a bigger share of every dollar spent on brand medicines (In fact, the amount these players are taking has increased to over 50% since we first ran this ad)
• Insurers and PBMs negotiate big rebates and discounts on medicine prices, but still make patients pay full price  

That’s why it’s important for Congress to pass strong PBM reforms this year, building on the legislative changes made in states across the country, that address the real challenges patients experience when they show up at the pharmacy.  

Get more facts about PBMs here.