Washington, DC — The Senior Care Pharmacy Coalition (SCPC) today praised a new report from the President Trump’s Council of Economic Advisors (CEA) that continues the drumbeat of findings that a “lack of transparency” among pharmacy benefit manager (PBM) middlemen is hurting consumers, and that an oligopolistic PBM market allows them to exercise undue market power against beneficiaries while “generating outsized profits for themselves.”
“In 2018, no player along the drug distribution chain faces a bigger challenge validating their legitimacy and value proposition than PBMs, who have transformed themselves into a classic oligopoly that puts their own profits ahead of Medicare beneficiaries’ well-being,” stated Alan G. Rosenbloom, President and CEO of SCPC, the only Washington-based organization exclusively representing the interests of long-term care (LTC) pharmacies and the patients they serve.
Rosenbloom noted that while the new CEA report specifically details the fact “three PBMs account for 85 percent” of the prescription drug market, this percentage jumps to more than 90% for seniors living in the nation’s long term care (LTC) facilities, and served by LTC pharmacies.
The CEA report also points out that, “Over 20 percent of spending on prescription drugs was taken in as profit by the pharmaceutical distribution system,” prompting Rosenbloom to observe, “Consumers in general and seniors in particular will benefit from enhanced congressional and regulatory scrutiny of each link in the drug supply chain.”
Rosenbloom also pointed out the anti-competitive environment and preponderance of new PBM “pharmacy fees,” “payment adjustments,” and other clawbacks imposed on LTC pharmacies have accelerated dramatically in just the past few years — drawing fresh attention from the Centers for Medicare & Medicaid Services (CMS). In late November 2017, the new CMS Parts C and D Proposed Rule for the first time stipulates the agency may, in fact, have the authority to exercise oversight over PBMs’ anti-competitive practices.
“For years, PBMs were able to hide behind a smokescreen of deception and falsehoods combined with the systemic complexity of the pharmaceutical distribution system,” Rosenbloom observed. “But now, after myriad official government reports and a landslide of other private analyses have exposed PBM’s to the harsh light of public scrutiny, we will continue to make the policy case that PBM abuses are unsustainable, and that Congress has the legal authority to act against them to benefit consumers.”
The SCPC is the national association for independent LTC pharmacies. Our member pharmacies provide care and services to patients in LTC facilities across the country occupying approximately 675,000 beds. Visit seniorcarepharmacies.org to learn more.