Patients Not PBMs Coalition to Push for Transparency
Around Pharmacy Benefit Managers (PBMs) Who Grab Savings Meant for Patients
For Immediate Release
Contact: Eileen O’Connor, 617-806-6999
eileen@keyserpublicstrategies.com
MARCH 16, 2023, Boston, MA – Today, Patients Not PBMs, a coalition of patient advocacy organizations, independent pharmacists and local business groups, announced its formation to push for legislation to force transparency around pharmacy benefit managers, or PBMs, and
their impact on drug costs. Several bills have been filed in the Massachusetts legislature that would require PBMs – who act like middlemen -- to be more transparent and to stop keeping rebates intended for patients and reimburse pharmacies fairly.
Patients Not PBMs coalition members include Lupus Foundation of New England, RARE New England, Diabetes Patient Advocacy Coalition (DPAC), Patient Pocket Protector Coalition, Institute for Pediatric Innovation, Cambridge Chamber of Commerce and PhRMA, with additional members expected to join.
“Patients are the ones who suffer when PBMs fail to pass along savings,” said Erin M. Callahan, Director of Communications at the Diabetes Patient Advocacy Coalition. “There are over 37 million Americans living with diabetes who are forced to overpay for their prescriptions, which may lead to rationing or even prescription abandonment. The rebates and discounts that PBMs supposedly negotiate on patients' behalf should be saving them hundreds or even thousands of dollars per year, but they are not getting them. It's time to put patients over profits."
“Independent pharmacies play a critical role in our communities. During the pandemic, they ensured patients received life-saving medications while providing immunizations and other critical services,” said Todd Brown, Executive Director of the Massachusetts Independent Pharmacists Association. “The time has come to simplify the pharmacy benefit, including reimbursement to pharmacies, and to increase transparency so that PBMs cannot manipulate the system to their own advantage at the expense of employers and patients. By holding PBMs’ feet to the fire, we can do just that.”
When patients pay for prescription drugs, more than half of the money goes to entities like insurance companies and their PBMs -- who act like middlemen and pocket billions of rebate dollars every year. PBMs are some of the most profitable corporations that most Americanshave never heard of. In 2021 alone, rebates, discounts and payments made by drug manufacturers to PBMs and insurers totaled $236 billion, but PBMs and insurers kept much of the rebate dollars for themselves.
Today’s “big three” PBMs – Express Scripts, CVS Caremark, and OptumRx, owned by UnitedHealth Group – control over 70 percent of the market, covering roughly 180 million prescription drug customers, and grab tens of billions of dollars in rebates and discounts on medicines that should be passed on to consumers.
Thousands of patients across the Commonwealth would benefit should legislation pass that would result in rebate dollars being shared with the patient at the pharmacy counter. However, Massachusetts is one of nine states that currently provide no oversight on PBMs. The issue is gaining attention, not only here in Massachusetts but in other states and at the national level.
The campaign includes coalition member thought leadership pieces in the Boston Business Journal and Commonwealth, digital ads running on social media platforms, online and via streaming services, and other targeted communications activities.
About Patients Not PBMs Coalition
Patients Not PBMs is a coalition of Massachusetts organizations that has formed to raise awareness around how pharmacy benefit managers (PBMs), or "middlemen," are putting profits before consumers' healthcare. The coalition’s focus is to educate consumers about PBMs, and to advocate for policy actions in Massachusetts that will prevent PBMs from continuing to drive up the price of prescription drugs by taking savings away that should be passed along to consumers.
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