Tampa Representative to Propose Plan to Hold Pharmacy Benefit Managers Accountable

Bay News 9  —  Tampa Rep. Jackie Toledo says she will soon refile a version of her 2020 proposed legislation that intends to lower prescription drug prices by holding pharmacy benefit managers (PBMs) more accountable.

PBMs are third-party companies that serve as intermediaries between drug companies and insurance companies. They pool money from contracted pharmacies to gain purchasing power, then negotiate rates and rebates with the pharmaceutical companies.

Their business agreements have raised questions about pricing transparency and state legislators, like Toledo, have been pushing to regulate PBMs in recent years.

“Right now, they’re unregulated, so they’re taking advantage of the system,” Toledo said.

“They’re pretty much dictating the cost of prescription drugs and right now there’s absolutely no transparency, so we don’t know how much they’re making,” she added.

John Noreiga has worked at his family-owned Bill’s Prescription Center in Brandon for nearly 40 years. The pharmacy has been around since 1956.

He says that for years the relationship “worked fantastically” between his independent pharmacy and PBMs, but says that changed when they became, “more savvy to the money that’s out there for rebates.”

Rebates are money refunded to the PBMs from the drug manufacturer, often in exchange for giving their drug preferred formulary placement.

report published earlier this year by the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California concluded that rebates play a role in increasing drug prices and that reducing or eliminating rebates could result in lower list prices and reduced out-of-pocket expenditures for some patients.

“A lot of times you come in with a prescription and they’re adjudicating that prescription and telling me to charge you $75, when I know I can sell you that drug for $23,” Noreiga says.  Continue Reading

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