EAIs vs. PBMs
If you are wondering why the cost of epinephrine and other drugs has been increasing lately, read about the role Pharmacy Benefit Managers (PBMs) play. While they are supposed to be acting as intermediaries between pharmacists and insurance companies, the way they are compensated can end up costing the consumer a lot more money. This article addresses gag clauses where the pharmacist is not allowed to suggest lower cost alternatives, rebates that give PBMs 40 to 50 percent of a medicine’s list price and spread pricing where the PBM charges an employer a higher price for a drug. Please read this important article here on how you can avoid gag clauses and save money when you go to fill your next prescription.
Understanding Pharmacy Benefit Managers and the Costs of Epinephrine
By Jon Terry
July 15th, 2018
Why has the excessive cost of epinephrine auto-injector (EAIs) devices become such a prominent public health issue? Along with the drug manufacturers and insurance companies, the news media has recently called attention to the role played by pharmacy benefit managers (PBMs) for increasing our medication expenses. According to the Council of Economic Advisors, “Pricing in the pharmaceutical drug market suffers from high market concentration in the pharmaceutical distribution system and a lack of transparency.” To help better understand this relationship, the Allergy Advocacy Association is sharing an overview of selected available information and opinions on this very complex subject.