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 The investigation comes against the backdrop of widespread criticism
of rising costs of prescription medicines in the United States, with
PBMs, middlemen who negotiate prices for employers and health
insurers, coming under intense scrutiny.
Ohio's attorney general earlier this week sued UnitedHealth Group's
OptumRx unit, which houses the largest U.S. health insurer's PBM
business, to recover nearly $16 million in prescription drug
overcharges. The lawsuit followed a probe that began under Governor
Mike DeWine before he left his position of attorney general earlier
this year.
Beshear said in a statement that he was seeking details on how PBMs
have determined, billed and paid drug reimbursement rates over the
past five years in Kentucky.
"PBMs were originally established to help companies and government
programs better manage pharmacy costs, but have grown into powerful
industry middlemen that go to great lengths to hide and complicate
drug pricing information," Beshear said.
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A report released last month by the state indicated that two PBMs
took in $123.5 million last year from the state Medicaid program by
paying pharmacies a lower rate to fill prescriptions, while charging
the state more for the same drugs, Beshear said.
Over 1.5 million Kentuckians receive pharmacy benefits through
Medicaid and the state employee health plan's PBMs, and thousands
more receive pharmacy benefits through PBMs retained by private
insurance plans, according to estimates.
(Reporting by Tamara Mathias in Bengaluru; Editing by Sriraj
Kalluvila)
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