Pharmacy Benefit Managers

President Joe Biden is campaigning on his efforts to cut drug costs for Medicare patients. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.

Independent pharmacists say they're losing money on many prescriptions they fill. “It’s just a lot of different elements in the system all at once," says a pharmacy assistant professor at FAMU.

A rule taking effect Jan. 1 was intended to stop one set of abuses by pharmacy benefit managers, but some pharmacists say it’s enabling these price brokers to simply do new things unfairly.

The governor moved quickly to sign a bill that will place restrictions on pharmacy benefit managers. The House and Senate unanimously passed the measureTuesday.

The bill is ready to go to Gov. Ron DeSantis, who during his annual State of the State address in March called for making PBM changes.

The issue has drawn heavy lobbying as pharmacy benefit managers play a central — and big-dollar — role in the health-care system.

The Senate Health Policy Committee approved the bill, while the House Healthcare Regulation Subcommittee is slated to take up its version on Tuesday.

Drugmakers long ceased to be the only villain of the insulin price scandal. While Lilly is cutting the list price and others may follow, will other "parties" (i.e. pharmacy benefit managers) cause the cost to increase before it hits the pharmacy counter?

Gov. Ron DeSantis plans to add controls on so-called middlemen in prescription transactions. Independent pharmacy owners have complained that PBMs have taken control of the financial market in the business.

The two men and six others were accused of deceiving pharmacy benefit managers into approving tens of thousands of prescriptions that were fraudulently obtained.

Small pharmacies have long complained about benefit managers, which represent health insurers in negotiations with drug companies and pharmacies

More than 100 bills have been introduced in 42 states this year to regulate these companies, which serve as conduits for drug manufacturers, health insurers and pharmacies.