Predictably Corrupt

The Federal Trade Commission has accused pharmacy benefit managers (PBMs) favor their affiliated pharmacies.

This disadvantages independent pharmacies, and raises costs for insurers and protesters.

The PBMs lobbying organization are arguing that the analysis is not accurate, MRDA:*

Pharmacy benefit managers (PBMs) often reimburse their own affiliated pharmacies at higher rates than they do independent pharmacies, to the disadvantage of insurers as well as taxpayers, the Federal Trade Commission (FTC) said.

"We see evidence PBMs pay their own pharmacies inflated prices," said Suzie Jing of the FTC's Office of Policy Planning, who presented interim results from the agency's report on PBMs at a commission meeting Thursday. For example, she said, in the case of generic abiraterone (Zytiga) for prostate cancer, "it costs $229 to buy the drug, but the big three PBMs pay their affiliated pharmacies about $6,000 per month on average. That's double the price paid to unaffiliated pharmacies ... This means that the PBM is overpaying itself at the expense of -- first, private insurance plans, which can lead to higher patient insurance costs; and second, at the expense of taxpayers who pay for Medicare."

Jing noted that the top six PBMs manage 94% of pharmacy claims. In addition, "based on our review to date, we find that there's often no negotiation for contract terms," she said. "The PBMs' internal memos reference 'unilateral' or 'passive' contracts, which are more like notifications -- often sent via fax -- outlining terms that take effect automatically, without the need for affirmative consent or signature. Reimbursement rates in these contracts can be unfavorable and potentially untenable, especially for local community pharmacies."

The FTC also found examples in which the PBMs' rebate contracts with drug manufacturers "are designed to limit access to affordable drugs and will exclude generic drugs from formularies ... this is disturbing," Jing said.

Seriously.  Let's just start jailing these assholes.

The whole business model is deeply corrupt and should be outlawed.

^*Well, he would say that, wouldn't he?  Seriously, know your history.