|
Op-Ed: Louisiana leads nation in creating
environment of drug-price transparency
[The Center Square] Randal Johnson |
Louisiana Independent Pharmacies Association
While no one disputes the
high cost of health care, it seems everyone has an opinion about what
would happen to prescription drug costs if pharmacy benefit manager (PBM)
middlemen were required to act in the interest of Louisiana employers
and our hard-working families. |
|
 Despite criticism to the contrary, Louisiana has led the nation
in passing laws that promote drug price transparency. Our elected leaders were
among the first to pass legislation prohibiting the use of PBM contract “gag
clauses” that prevented pharmacists from disclosing to patients whether a
lower-priced but therapeutically equivalent drug was available.
Ending the use of gag clauses and other opaque PBM business
practices, including steering patients to PBM-owned or affiliated pharmacies,
has gone a long way to protect Louisiana’s hard-working families from paying too
much at the pharmacy counter, while also protecting local employers from paying
higher-than-necessary premiums each month.
Transparency’s most vocal critic is the PBM trade association, the
Pharmaceutical Care Management Association (PCMA), a $28.5 million lobby
representing the 18 largest PBMs in the country. PCMA commissioned the Visante
report referenced in a previous op-ed.
 PCMA’s three largest members – CVS Caremark, OptumRx and Express Scripts –
together hold 80% of the market. That means 80% of all prescriptions processed
in the U.S. go through one of the “Big Three” and each of the “Big Three” own or
are owned by health insurers ranking fourth, fifth and 13th, respectively, on
the Fortune 500. With that kind of market share to protect, PBM spokespeople
naturally will say transparency will drive up consumer costs at the pharmacy.
[to top of second column] |
Extreme market consolidation allows the largest PBMs to contractually forbid small business pharmacies from offering
everyday services such as prescription drug delivery. PBMs can and
do bar independent pharmacies from dispensing certain “specialty”
medications, routing such prescriptions to their own pharmacies
under exclusive rights they’ve given themselves – even though an
independent pharmacy meets the qualifications to dispense specialty
medications.
Like “Big Tech,” in which you either accept your
smart phone’s terms and conditions or you can’t use your phone, “Big
PBMs” are a “take-it-or-leave it” proposition – for everyone. In the
end, it’s the consumers who pay the price for the rigid benefit plan
rules that prevent them from using the pharmacy provider of their
choice.
Louisiana’s independent pharmacies are committed to
transparency, and will continue to put the needs of patients and
local employer plan payers first as we attempt to work with the
opposition. Working together, we’re confident Louisianans will reap
the benefits of a fair, equitable and transparent healthcare
environment.
• Randal Johnson is president and chief executive officer of the
Louisiana Independent Pharmacies Association.
 |
