The Medicare Modernization Act required the Federal Trade Commission to investigate whether Pharmaceutical Benefit Manager (PBM) owned mail order pharmacies are more expensive than mail order pharmacies not owned by PBMs. The report, Pharmacy Benefit Managers: Ownership of Mail-Order Pharmacies was issued yesterday. The answer: No, PBM-owned mail order pharmacies are not more expensive.
There are a few other interesting findings:
- Rates of generic substitution are roughly equal at PBMs and retailers. Although PBMs generate revenues from drug companies for offering branded products, prices they pay for generics are so low that generics are still good money makers
- PBMs “rarely” switched patients from one brand drug to another
- PBMs “rarely” sold repackaged drugs (although theoretically this could generate good profits if the pricing of bulk packaging is lower per unit than for smaller packages)
A report that portrays PBMs in such a good light is unusual and a bit surprising, given the secrecy and lack of transparency of the PBM industry. The question remains, though, of whether PBMs could be doing a better job of saving money for their customers.September 7, 2005