Cantwell measure targets hidden fees

October 12, 2009

As appeared in The Daily Herald (Everett, Washington) 
Holly Whitcomb Henry, RPh
President, National Community Pharmacists Association
Seattle

Anyone who thinks prescription drug coverage costs too much should thank Sen. Maria Cantwell for her successful efforts to get an amendment adopted in the Senate Finance Committee's health care reform bill. It targets the ballooning fees that pharmacy benefit managers (PBMs) impose on patients and health plan sponsors. 

PBMs have grown from drug claim processors to multi-billion dollar corporations who keep an inordinate amount of the money for themselves. In fact, PBMs like CVS Caremark, Express Scripts, Inc. and Medco Health Solutions, Inc., reported a 20 percent increase in profits last year. Increasingly, plan sponsors are beginning to catch on and are taking steps to reduce or eliminate their use of PBMs. 

Without transparency, it's impossible to judge what s going on. Cantwell's amendment requires PBMs to provide basic information so health plan sponsors can make informed decisions. These requirements only apply to PBMs operating in the health insurance exchanges created by the bill, but is an important step. 

Community pharmacies are grateful for Sen. Cantwell's leadership, and patients should be, too. 

The full article is available online.

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