REAL CLEAR HEALTH – The Trump Administration’s efforts to lower prescription drug prices has resulted in progress on a new approach to getting brand name drug manufacturers to announce price reductions in connection with direct-to-consumer avenues for Americans to access some of their products.
Selling to direct-to-consumer has been characterized by some as a way to work around consumers’ pharmacy benefits – the reality is that America’s pharmacy benefit managers (PBMs) stand ready to support the Administration’s work to foster more options for patients and consumers by bringing to the table our expertise and ability to lower drug costs and support patient safety.
There is enormous upside to making sure that direct-to-consumer options are pulled through to consumers’ insurance coverage to ensure they are not only getting the lowest cost for their medication, but that their safety and clinical needs are being taken care of.
Our industry commends the President and his Administration for their ongoing work to deliver a better deal for American patients, and for rightly recognizing that big drug companies set the price, can lower the price at any time — and that the price is the problem when it comes to Americans being able to afford their prescription drugs. PBMs support lower list prices for all drugs and welcome more options and greater competition across the entirety of the prescription drug marketplace.
PBMs deliver savings for consumers and patients who have prescription drug benefits by negotiating on behalf of health plan sponsors against big drug companies and maintaining accessible and affordable pharmacy networks, saving patients and payers on average $1,154 annually.
This work results in low out-of-pocket costs for most insured patients for most drugs. PBMs also provide specialized clinical expertise to patients that supports adherence to treatment, prevents medication errors and negative drug-drug interactions, and promotes better health outcomes.
In fact, PBMs are helping patients avert a projected one billion medication errors over the next 10 years, improving drug therapy and patient adherence in patients with diabetes, and supporting convenient home delivery of medications and access to uniquely sophisticated specialty pharmacies for the most complex medicines and conditions.
So, it should come as no surprise that PBMs already work with direct-to-consumer sales models in the market today to provide this specialized support through the unique role our industry plays in the supply chain as the only participant with broad visibility into patients’ affordability and safety needs.
Mail-order pharmacies operated by PBMs today provide a convenient, reliable, and affordable option for patients, including those in rural areas, to safely access prescription drugs.
Drug manufacturers set the list price of the medications they market. Their ability to announce that they will provide medications direct-to-consumers at a different price than they offer in other settings, as well as past actions to lower the price of insulin and other products under immense public pressure, clearly show that they can simply lower the prices, at any time.
PBMs support efforts to lower prescription drug costs and PBMs have always supported greater competition in the health care system. Whether through traditional pharmacies, direct-to-consumer programs, or other avenues, we are committed to reducing drug costs in any way possible, while upholding patient safety and health outcomes.
We will also continue to support policymakers’ calls for lower drug prices for the American people. PBMs have repeatedly called on Big Pharma to lower list prices, and supported the work from the White House, and from Republicans and Democrats in Congress, to advance bipartisan reforms that would eliminate unnecessary red tape and foster greater competition from generics and biosimilars.
The industry applauded the Administration’s recent announcement to remove the unnecessary step of providing studies for biosimilar interchangeability and make biosimilars more accessible for patients. These actions, along with cracking down on Big Pharma’s outrageous spending on misleading advertising for blockbuster brand-name products that increases costs for taxpayers and patients, will deliver real affordability.
More competition among drug companies and new models for patients to access medications are welcome — and we will work with the Administration and Congress to make prescription drugs affordable, safe, and accessible for every American.
JC Scott is the president and CEO of the Pharmaceutical Care Management Association (PCMA).
