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Pharmacy benefit managers play a pivotal role in negotiating the prices for prescription drugs, but many officials believe their tactics warrant reform. Below, a pharmacist says California lawmakers should proceed with caution as they consider new restrictions. The opposing view: A community pharmacy owner argues these middlemen need to be reined in.
As a lead pharmacist in San Francisco, I see firsthand how the cost of medications can be as overwhelming as the diseases they’re supposed to treat.
Every day, my team of pharmacists and technicians helps patients navigate complex conditions such as cancer, autoimmune disorders and multiple sclerosis. A cancer diagnosis is difficult enough; but for many patients, the challenge is compounded by the soaring price of their oncology medications, which can cost thousands of dollars a month.
While pharmacy teams can often provide some relief by connecting patients with financial assistance programs, so-called pharmacy benefit managers work to bring down prescription costs by negotiating directly with drug manufacturers.
Earlier this year, California enacted new transparency requirements across the prescription drug supply chain, including enhanced reporting standards for benefit managers, also known as PBMs.
Before fully understanding the effect of these changes, California is now considering new legislation that would limit pharmacy benefit managers’ ability to negotiate lower drug prices. Senate Bill 41 would eliminate one of the most effective tools pharmacy benefit managers have for controlling prescription costs, potentially devastating patients, who rely on the savings pharmacy benefit managers help secure and which employers and unions pass on.
Rather than rushing to adopt additional restrictions, California lawmakers should take time to accurately assess the impact of this year’s transparency reforms. They should realize that effective cost controls require all parties of the health care system to work together.
Over my career, I’ve watched countless patients rely on their pharmacists for help. Many patients have serious concerns about their prescriptions, including potential side effects. Patients deserve to focus on their health, not on whether they can afford their medication. California’s legislators must proceed carefully. If done improperly, additional pharmacy benefit restrictions could prevent patients from accessing the life-saving medications they need.
