It looks as if pharmacy benefits managers are going to have to 'fess up to their deals with drugmakers one way or another. Either the government will force PBMs to disclose what they pay for drugs and what they charge insurers--and to tell all about rebate deals with drugmakers. Or big employers will keep pushing for the info themselves, following in the footsteps of one group that's managed to get 15 of the drug-benefits administrators to talk, the Wall Street Journal reports.
A proposal now floating around Congress would mandate that disclosure; sponsored by Rep. Anthony Weiner, the provision is part of one version of healthcare reform legislation that made it through the House Energy and Commerce Committee. The goal is to make sure PBMs aren't fleecing Medicare and other insurers. But disclosure would also expose pharma's marketing machinations, which often include rebates designed to get PBMs to promote certain drugs. As Weiner told the Journal, it would "cut down on inside deals that benefit only the PBMs and the drug companies."
But even if Weiner's proposal fails, PBMs will find themselves sharing more information about their deals with drugmakers and insurers: Some 60 big companies including McDonald's and IBM are working together to get that info, and they've succeeded in persuading 15 PBMs, including Medco Health Solutions and CVS Caremark, the WSJ says. And experts predict other companies will follow suit.
Meanwhile, PBMs aren't happy about the trend. They say they need secrecy to get the best deals they can from drugmakers. Viewed that way, however, the transparency idea could be good for pharma, yes? Without disclosure, their rebates stay secret. With that, they'll get better prices from PBMs. What do you think?
- see the WSJ story