A coalition of pharmacy benefit managers (PBMs) has taken an innovative step to counter the negative image that has dogged the industry, launching a substantial digital media campaign with a budget in the six figures. This campaign aims to emphasize the value that certain PBMs provide to the healthcare system.
In recent years, PBMs have endured considerable criticism, with organizations like PhRMA portraying them as middlemen who profit without adding real value. This narrative is driven, in part, by a desire to shift blame for high drug prices from pharmaceutical manufacturers to PBMs. This perspective has also been echoed by various stakeholders, including pharmacies and employer representatives.
In this contentious environment, a group of PBMs has chosen to take a different approach. These PBMs have formed a non-profit coalition named Transparency-Rx, and they are determined to distinguish themselves from the practices that have brought criticism to the PBM industry. Transparency-Rx represents “transparent” PBMs such as AffirmedRx and Liviniti. The coalition is focused on conveying the message that transparent PBMs do indeed provide value. They claim that local businesses working with their members save an average of $20 per prescription compared to other PBMs. Transparent PBMs, according to the group, reduce out-of-pocket costs, expedite access, and eliminate conflicts of interest.
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To amplify their message and influence the PBM landscape, Transparency-Rx has launched an ad campaign. This campaign will reach out to policymakers and stakeholders who have the power to shape PBM-related legislation. The ads will be featured on news sites, cable networks, and streaming platforms in Washington, D.C. (referred to as the Beltway) and in select markets across the US. The campaign aims to reach more than 16 million individuals, providing valuable insights to inform PBM reform legislation.
“Medicare and the commercial market desperately need the important PBM reforms Republicans and Democrats are championing in Congress to help patients and local businesses drastically reduce medical costs.”
– Joseph Shields, managing director at Transparency-Rx
Transparency-Rx underlines the contrast between the clear, disclosed fees charged by transparent PBMs and the conventional “big three” PBM model represented by CVS Caremark, Express Scripts, and OptumRx, who collectively dominate the PBM market. The traditional model ties profits and fees to drug prices, potentially incentivizing the promotion of brand-name or higher-cost medications over generic alternatives.
Also Read: PhRMA Moves Forward With The Medicare Pricing Talks
The coalition advocates for fundamental reforms in the PBM industry, including “delinking” PBM fees from drug prices, which is consistent with Senate PBM bills. Transparency-Rx also supports additional changes, such as a ban on spread pricing and the reform of group purchasing organizations affiliated with major PBMs.
As the PBM industry grapples with increased scrutiny and criticism, Transparency-Rx’s efforts aim to bring transparency, cost savings, and value to the forefront, with the potential to shape future PBM regulations and positively impact healthcare costs for patients and businesses alike.
