Opinion: Missing from the PBM hearings: value-based drug reimbursement
Missing from this week's congressional PBM grillings was talk about the value of medications, which is sorely need to ensure we are spending the right amount of money on the…
This week, committees in both the Senate and House of Representatives used their power to shine a light on one of the most complex and opaque parts of the prescription drug equation: the practices of pharmaceutical benefit managers.
These third-party companies are hired by Medicare, Medicaid, and commercial health plans to create and manage pharmaceutical benefits for more than 266 million Americans. They determine what drugs are covered in their formularies, negotiate prices for these drugs with their manufacturers, set copays for consumers, determine which pharmacies will be included in prescription plans, and decide how much pharmacies will be reimbursed for
