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Article CommentaryCommentary

Pharmacy Benefit Managers in the Eye of the Storm: Growing Multipartite Scrutiny

Eli Y. Adashi, Daniel P. O’Mahony and David S. Guzick
The Journal of the American Board of Family Medicine November 2023, 36 (6) 1065-1067; DOI: https://doi.org/10.3122/jabfm.2023.230102R1
Eli Y. Adashi
From the Professor of Medical Science, Brown University, Providence, RI (EYA); Brown University Library, Providence, RI (DPO); University of Rochester School of Medicine and Dentistry, Rochester, NY (DSG); UF Health, University of Florida, Gainesville FL (DSG).
MD, MS
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Daniel P. O’Mahony
From the Professor of Medical Science, Brown University, Providence, RI (EYA); Brown University Library, Providence, RI (DPO); University of Rochester School of Medicine and Dentistry, Rochester, NY (DSG); UF Health, University of Florida, Gainesville FL (DSG).
MSLS
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David S. Guzick
From the Professor of Medical Science, Brown University, Providence, RI (EYA); Brown University Library, Providence, RI (DPO); University of Rochester School of Medicine and Dentistry, Rochester, NY (DSG); UF Health, University of Florida, Gainesville FL (DSG).
MD, PhD
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References

  1. 1.↵
    RAND Corporation. International prescription drug price comparisons: current empirical estimates and comparison with previous studies. 2021. Available at: https://www.rand.org/pubs/research_reports/RR2956.html.
  2. 2.↵
    1. Peter G
    . Peterson Foundation. How much does the United States spend on prescription drugs compared to other countries? Accessed November 7, 2022. Available at: https://www.pgpf.org/blog/2022/11/how-much-does-the-united-states-spend-on-prescription-drugs-compared-to-other-countries.
  3. 3.↵
    PBM Accountability Project. Understanding the evolving business models and revenue of pharmacy benefit managers. 2021. Available at: https://7f0edfbb-d1c0-491c-a980-f6efff91f8f6.filesusr.com/ugd/b11210_264612f6b98e47b3a8502054f66bb2a1.pdf?index=true.
  4. 4.↵
    Federal Trade Commission. FTC launches inquiry into prescription drug middlemen industry. Accessed June 7, 2022. Available at: https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-launches-inquiry-prescription-drug-middlemen-industry.
  5. 5.↵
    Federal Trade Commission. FTC deepens inquiry into prescription drug middlemen. Accessed May 17, 2023. Available at: https://www.ftc.gov/news-events/news/press-releases/2023/05/ftc-deepens-inquiry-prescription-drug-middlemen.
  6. 6.↵
    Khan, Lina M. Remarks of Chair Lina M. Khan, How pharmacy benefit managers impact drug prices, communities, and patients. Accessed June 22, 2022. Available at: https://www.ftc.gov/system/files/ftc_gov/pdf/Remarks-Lina-Khan-Economic-Liberties-National-Community-Pharmacists-Association.pdf.
  7. 7.↵
    U.S. Department of Health and Human Services, Office of Inspector General. The District of Columbia has taken significant steps to ensure accountability over amounts managed care organizations paid to pharmacy benefit managers. Accessed March 16, 2023. Available at: https://oig.hhs.gov/oas/reports/region3/32000200.asp.
  8. 8.↵
    Grassley Bipartisan Bill. Commerce committee approves Cantwell, Grassley bipartisan bill to combat rising prescription drug prices. Accessed March 22, 2023. Available at: https://www.grassley.senate.gov/news/news-releases/commerce-committee-approves-cantwell-grassley-bipartisan-bill-to-combat-rising-prescription-drug-prices.
  9. 9.↵
    1. Mattingly TJ 2nd.,
    2. Lewis M,
    3. Socal MP,
    4. Bai G
    . State-level policy efforts to regulate pharmacy benefit managers (PBMs). Res Social Adm Pharm 2022;18(11):3995–4002.
    OpenUrl
  10. 10.↵
    New Pharmacy Benefits Bureau. New York State Governor Hochul announces new watchdog bureau to tackle prescription drug costs. Accessed May 11, 2022. Available at: https://www.governor.ny.gov/news/governor-hochul-announces-new-watchdog-bureau-tackle-prescription-drug-costs.
  11. 11.↵
    American Medical Association. Policy research perspectives. Competition in commercial PBM markets and vertical integration of health insurers with PBMs. Accessed October 13, 2022. Available at: https://www.ama-assn.org/system/files/prp-pbm-shares-hhi.pdf.
  12. 12.↵
    1. Daniel H,
    2. Bornstein SS
    . Policy recommendations for pharmacy benefit managers to stem the escalating costs of prescription drugs: a position paper from the American College of Physicians. Ann Intern Med 2019;171(11):823–824.
    OpenUrl
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The Journal of the American Board of Family     Medicine: 36 (6)
The Journal of the American Board of Family Medicine
Vol. 36, Issue 6
November-December 2023
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Pharmacy Benefit Managers in the Eye of the Storm: Growing Multipartite Scrutiny
Eli Y. Adashi, Daniel P. O’Mahony, David S. Guzick
The Journal of the American Board of Family Medicine Nov 2023, 36 (6) 1065-1067; DOI: 10.3122/jabfm.2023.230102R1

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Pharmacy Benefit Managers in the Eye of the Storm: Growing Multipartite Scrutiny
Eli Y. Adashi, Daniel P. O’Mahony, David S. Guzick
The Journal of the American Board of Family Medicine Nov 2023, 36 (6) 1065-1067; DOI: 10.3122/jabfm.2023.230102R1
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Keywords

  • Drug Costs
  • Government Regulation and Oversight
  • Health Insurance
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  • Pharmacy Benefit Managers
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