In a recent interview with Pharmacy Times, Cheryl Larson, president and CEO of the Midwest Business Group on Health, discussed the longstanding issues associated with pharmacy benefit managers (PBMs) and the ongoing reform efforts. Larson emphasized the lack of transparency in the PBM industry, affecting employers who are fiduciaries obligated to offer the best benefits at the best price.
Larson highlighted PBM practices such as retaining rebates, keeping the spread, and employing opaque business practices that contribute to rising costs. Larson also touched on legislative efforts, including the Pharmacy Benefit Manager Reform Act, aiming to address these challenges and enhance value for workers and their families. Despite bipartisan support for certain bills, substantial federal movement remains a challenge, with employer coalitions playing a crucial role in advocating for reform.
Larson discussed the Consolidated Appropriation Act, emphasizing employers' fiduciary duty and the need for transparency regarding indirect compensation. She recommended employers audit their plans, optimize PBM contracts, and be prepared to walk away for fair terms. Larson concluded by dispelling the notion that employers universally love their PBMs, calling for common-sense changes and legislation to address rebates, fees, and discounts for informed decision-making.
Full article from Pharmacy Times here.