PBMs say they save employers money on prescription drugs. Employers should be able to check the math.
On the latest PBM Reform Podcast, APCI Vice President of Public Policy Greg Reybold and Antonio Ciaccia, president of 3 Axis Advisors, discuss why following the money can be difficult and what employers and independent pharmacies should know about the financial incentives behind PBM contracts.
The two also discuss a recent 3 Axis Advisors study comparing commercial PBM charges with published prices for prescriptions available through Mark Cuban Cost Plus Drug Company. For those prescriptions, Cost Plus Drugs’ prices were about 67% lower than gross charges under the PBM arrangements examined. The comparison does not account for all manufacturer rebates or establish that employers could cut their total drug spending by 67%. Cost Plus Drugs sponsored the research.
Even with those limitations, the findings give employers another benchmark for evaluating what they pay for prescriptions under traditional PBM arrangements.
For independent pharmacies, the issue is familiar: What an employer pays for a prescription often bears little resemblance to what the pharmacy receives for dispensing it.
Reybold and Ciaccia examine those competing financial interests, how PBM savings claims hold up to scrutiny, and where legislation, litigation, and market competition could force changes.
Listen to “Follow the Money, Expose the System, Demand Accountability” on the PBM Reform Podcast.