Bay News 9
When State Rep. Jackie Toledo (R-District 60) recently tried to fill a prescription for her daughter, she was surprised at how much the drug cost.
“Originally, it was going to be $25,” Toledo said. “The pharmacy told me it was going to be $480.”
Toledo says although she had a coupon that would have kept the cost at $25, the pharmacist initially refused to accept it. After a back and forth that lasted about 90 minutes, he went ahead and filled the prescription at the reduced price.
“They said, ‘It’s because our PBMs would not take it,’ and that’s when I learned about the term PBMs,” she said.
“PBMs” or prescription benefit managers, are a group of companies that work to lower prescription drugs costs by negotiating prices directly with drug makers.
They often recommend health care plans use mail order drugs over traditional pharmacies which some pharmacists say is not always ideal.
“When they’re forced to use a mail order pharmacy, they have no choice,” said Kevin Duane, a Jacksonville-area pharmacist who co-founded “Small Business Pharmacies Alligned For Reform” or “SPAR.”
“They can’t chose to see a pharmacist who looks like them, a pharmacist who grew up in the neighborhood,” said Duane.
What’s more, Duane doesn’t believe PBM recommendations are cost-effective. Continue Reading