Are you paying too much for your prescription drugs? The state’s auditor general says it’s likely. Now, he’s calling on lawmakers at the State Capitol to take action.
Auditor General Eugene DePasquale pointing the finger at pharmacy benefit managers. They negotiate with drug companies and insurers to decide which drugs are covered by health plans. And, he says, they do so with little to no oversight.
“Their prescription drugs are what keep them out of the hospital. And the cost of those prescription drugs keep going up.”
Speaking to the House Health Committee on Wednesday, DePasquale talked about his office’s special report on pharmacy benefit managers, or PBM’s. He says they decide which drugs can be covered by health plans and set the price in so-called ‘Take it or Leave it’ contracts.
“The local, independent pharmacist gets squeezed by that. And two weeks later, they get a letter saying ‘Hey, do you want to sell to us?’ That system can not be tolerated.”
The four major PBM’s in Pennsylvania receive state and federal funding and are costing taxpayers more with growing Medicare and Medicaid costs with little state or federal oversight.
The auditor general made recommendations for legislation he’d like to see passed, like allowing the state to perform reviews of PBM subcontracts, increasing transparency into PBM pricing practices. And, banning ‘gag rules’ that prevent pharmacists from voluntarily telling patients when they can save money on medication.
“Pennsylvanians are paying more for prescription drugs than they should, because of an opaque system with no oversight and accountability.”
And, the auditor general said he’s hoping to work with lawmakers to craft legislation with the hope of getting a bill to the governor’s desk later this year.