Small pharmacies compel lawmakers to rein in drug middleman

Wyoming lawmakers are considering adding more regulations to an obscure yet powerful link in the pharmaceutical drug supply chain — pharmacy benefit managers. PBMs work behind-the-scenes as middlemen between insurance plans, drug manufacturers and pharmacies. Public scrutiny has led many states to pass legislation to better regulate PBMs. That includes Wyoming, which has added four PBM measures to its statutes since 2016.

Now, the Legislature is considering adding several more regulations to the books with House Bill 36 – Pharmacy benefit managers act enhancements. The bill has sparked much ado among lawmakers and stakeholders about how exactly PBMs work and who they are costing or saving money.

What’s a PBM?

PBMs are multi-million dollar companies that manage prescription drug benefits on behalf of health insurers or large employers. They negotiate discounts, rebates and reimbursements, and purport to provide the sole source of downward pressure on the rising cost of drugs. They can also make money by pocketing some of the cash saved through those negotiations.

That’s where some parties,including many independent pharmacists in Wyoming, take issue. Last spring, more than 20 of them requested the Joint Labor, Health and Social Services Committee study PBM regulation in the last interim. The concerned pharmacists say such companies harm their businesses by not properly reimbursing them, and asked the committee to create legislation mimicking regulations passed by Arkansas.

Read more: https://wyofile.com/small-pharmacies-compel-lawmakers-to-rein-in-drug-middleman%ef%bf%bc/


Pharmacy benefit managers act as a middleman between insurance plans, drug manufacturers and pharmacies. (Elizabeth Seeley and Aaron S. Kesselheim/Commonwealth Fund)