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Letter to the editor: PBMs continue to drive up out-of-pocket costs for patients

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Letter to the editor by Aaron Mierzwiak, President of the Ohio Medical Group Management Association

A recent story by Marty Schladen, ‘Biden administration announces ‘comprehensive’ plan to fix high drug prices’, uncovered more of the countless reports about how pharmacy benefit managers, or PBMs, continue to drive up out-of-pocket costs for patients with very little accountability or transparency.

After years of PBM efforts to keep their operations under wraps, the State of Ohio will go to trial soon to throw open the curtains. But Ohio didn’t wait for a verdict to challenge these invisible policies. The state recently took a significant step forward in reforming how PBMs contract with public-sector employee prescription drug benefits and other state-run public programs. The new budget includes plans for a PBM “reverse auction,” which modernizes the way we do business with these middlemen.

A reverse auction creates a transparent marketplace for PBMs to compete with one another over multiple bidding rounds to win a contract with the state. PBMs would be forced to lower what they charge for business and thus provide the state the best deal on prescription medications, generating significant financial savings for Ohio taxpayers.

As the leading association for medical practice administrators and executives, we thank Governor DeWine and policymakers for initiating the reverse auction in our state, which has had tremendous financial success in New Jersey and will soon bring savings to New Hampshire, Minnesota, and Colorado. Ohio deserves these savings as soon as possible.

Our members support any effort with a goal to identify solutions to help redirect savings back to the patients and taxpayers and we look forward to more innovative, meaningful policy solutions to do just that.


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