On the heels of the FTC’s investigation into pharmacy benefit managers for what many regard as anti-competitive business practices, legal pressure is continuing to mount. At least six state Attorneys General, including California, Ohio and most recently Vermont, have initiated lawsuits against PBMs. Additionally, recent House oversight investigation findings bolster these claims, revealing that these drug middlemen–who claim to control costs–have instead “steered patients toward higher-priced medicines and affiliated pharmacies.”
As these inquiries, investigations and lawsuits keep PBM practices in the public eye, it’s important that lawmakers, employers and the general public understand not just what these practices are but how they relate to the larger healthcare market. PBMs are one piece of the jigsaw puzzle of healthcare, and they affect consumers’ cost and quality of care. For employers, the relationship with PBMs is complex and often opaque, impacting their ability to provide cost-effective and high-quality healthcare benefits to their employees.
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