Talk:Pharmacy benefit management

Edits by PBMs

Several edits are clearly being done by PBM companies to erase or better improve their image. These edits are being done without citations and, as user:67.167.249.170 pointed out, a lot of it sounds like marketing junk. Canadacow (talk) 16:54, 20 June 2012 (UTC)

A lot of the stuff under "PBM Strategies and Tools" sounds like marketing junk. 67.167.249.170 (talk) 23:16, 14 September 2010 (UTC)

List of Pharmacy benefit managements

http://www.pharmacyzone.com/pharmacy-benefit-manager-directory.htm — Preceding unsigned comment added by Prathyush1432 (talk • contribs) 02:36, 17 November 2012 (UTC) PBMs rake in huge profits at the expense of retail pharmacies. It is commonplace for a pharmacy to be reimbursed below product cost and the small amount of profit built in to contracts do not come close to covering the overhead costs of the pharmacy. — Preceding unsigned comment added by 173.24.134.134 (talk) 05:43, 27 May 2013 (UTC)

This is quite sloppy. It talks of PBM benefits being available to over 400 million Americans, but the U.S. population was only 318 million in 2014. — Preceding unsigned comment added by 149.142.103.92 (talk) 19:08, 24 September 2015 (UTC)

The PBMs have no incentive to reduce costs

PBMs don't reduce costs, they are only motivated by their profits and there profits are not linked to cost containment. They have a monopoly position and like any other monopoly, they inflate cost to the public.

Lil bklyn (talk) 12:20, 26 January 2018 (UTC)

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This is the talk page. The idea that PBMs are in business of the public benifit is extremely irration and fringe theory that is not supported in the literature, which has no citations and which a fraud.

unsourced

moved here per WP:PRESERVE. Per WP:BURDEN, please don't restore without finding reliable sources, checking this against them, and citing them

The provisions require PBMs to disclose all rebate, discount, and revenue arrangements made with drug manufacturers, including all utilization information on covered individuals.

Fiduciary duty provisions have stirred the most controversy. They require PBMs to act in the best interest of health plans in a way that conflicts with PBMs' role as the intermediary, which is the foundation of the PBM industry. The Pharmaceutical care management association, the national trade association representing PBMs, starkly opposes legislation of this kind. The PCMA believes public disclosure of confidential contract terms would damage competition and ultimately harm private and public sector consumers. The association also argues that transparency already exists for clients that structure contracts to best suit their needs, including imposing audit rights.

Maine, South Dakota, and the District of Columbia have laws requiring PBM transparency. PCMA filed suit against Maine and the District of Columbia for their financial disclosure laws.

In the Maine lawsuit, PCMA v. Rowe, PCMA alleged the law:

• Destroys the competitive market and will result in higher drug costs for Maine consumers
• Deprives PBMs of proprietary information and trade secrets
• Conflicts with the Employee Retirement Income Security Act and the Federal Employees Health Benefit Act
• Violates the "taking and due process" clause of the U.S. and state constitutions
• Allows for broad enforcement of violation under the Maine Unfair Trade Practices Act

PCMA won preliminary injunctions against the Maine law twice but was denied its motion for summary judgment. The judge agreed that financial disclosure was reasonable in relation to controlling the cost of prescription drugs. It was determined that the law was designed to create incentives within the market to curtail practices that are likely to unnecessarily increase costs without providing any corresponding benefit to those filling prescriptions. PCMA won an interim injunction against the D.C. law, with the judge ruling that it would be an "illegal taking" of private property.

-- Jytdog (talk) 22:41, 31 January 2018 (UTC)

Discount prescription cards for general public

Some PBMs use their supplier discount contracts to also operate publicly-available prescription discount cards, which any one can usa at many pharmacies to obatain a discount on a prescription price. E.g, GoodRX, SingleCare, RxSaver, WellRx. I myself do not understand well enough the connection between these card operators and their parent PBSs to write about them. Perhaps some better-informed editor could write a section about this. Acwilson9 (talk) 20:00, 7 May 2022 (UTC)

Wiki Education assignment: Research Process and Methodology - FA23 - Sect 202 - Thu

This article was the subject of a Wiki Education Foundation-supported course assignment, between 6 September 2023 and 14 December 2023. Further details are available on the course page. Student editor(s): ChrisMisu (article contribs).

— Assignment last updated by ChrisMisu (talk) 18:20, 1 December 2023 (UTC)

On Point

The On Point program on PBS on 14 December 2023 has a one-hour session exclusively on PBMs. I think it be added as a "see also." Kdammers (talk) 19:43, 14 December 2023 (UTC)