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Most Favor PBM Rules | 2023 Annual Managed Healthcare Executive Pharmacy Survey
Aside most of the 311 respondents to the 2023 Annual Managed Healthcare Executive Pharmacy Survey favoring PBMs, two-thirds indicated they favor restrictions on rebates and discounts so PBMs won’t favor drugs with high discounts. A similar proportion favor transparency rules that would require disclosure of rebates and discounts.
Pharmacy benefit managers (PBMs) are coming under scrutiny in Washington these days, and bills have been introduced in both the House and Senate that would ban certain practices (such as spread pricing), create new regulations and require much greater disclosure of their business practice.
By a sizable majority, most of the 311 respondents to the 2023 Annual Managed Healthcare Executive Pharmacy Survey favor reining in PBMs. Two-thirds (66%) indicated that they favor restrictions on rebates and discounts so PBMs won’t favor drugs with high discounts. A similar proportion (63%) favor transparency rules that would require disclosure of rebates and discounts. The PBMs have long argued that some secrecy about rebates and discounts is needed for them to bargain effectively.
The online survey was conducted Feb. 14-28. The respondents were spread fairly evenly across the various sectors of the U.S. healthcare industry, with 20% self-identifying as working for hospitals, 22% for physician practices, 19% for pharmacy benefit managers, 16% for payer organizations, 13% for drug and device manufacturers and the rest in a variety of sectors.
A Conversation With Greg Baker, RPh, CEO of AffirmedRx
March 31st 2024Greg Baker, CEO of AffirmedRx, describes his early career, shares some of his critical opinions about the pharmacy benefit management (PBM) industry and how, in his view, his company is offering a better alternative.
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David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
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Florida Gets the OK. But Will Drug Importation from Canada Actually Happen?
March 5th 2024Canadian health officials warn that maintaining a drug supply for Canadians is their priority. The staunch opposition of the U.S. pharmaceutical industry may also be an obstacle to imports from north of the border.
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Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.
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What Payers Need to Know As Retail Pharmacies Move Into Primary Care
September 6th 2023Healthcare beyond the doors of the doctor’s office has the potential to offer more care to more people. But payers need to think about how to ensure that care is consistent. Regardless of the setting, care decisions must be based on evidence-based content and supported with strong patient education.
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