April 11, 2018 – Pharmacy Benefits Managers

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Anchor lead: Pharmacy benefits managers are in the crosshairs as many try to rein in drug prices, Elizabeth Tracey reports

Drug prices, even for many generics, are too high and seem to keep heading upward, with pressure mounting on lawmakers and administration officials to do something, recent federal activity reveals. Joseph Cofrancesco, an internal medicine expert at Johns Hopkins, says the problem is out of control, with pharmacy benefits managers part of the problem.

Cofrancesco: The price of drugs just keeps going up and up and up to the point of absurdity. So to control that there have been these pharmacy benefit managers, who alter these plans to try to cut back costs. They also cut deals with manufacturers and generic manufacturers and everything else and go through their hoops. So every year their formularies change and one drug is out and another is in, and patients don’t get their meds until they figure out they should call us and tell us they’re not getting them, and we learn oh, that one’s off the formulary, and now you have to use something else.  :31

Cofrancesco says he sees middle income patients as experiencing the heaviest impact, with many simply choosing to go without needed medications. At Johns Hopkins, I’m Elizabeth Tracey.