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Readers Write: Pharmacy benefit managers

Thank goodness for the scrutiny


Kudos to state Attorney General Keith Ellison and the other attorneys general for scrutinizing the unfair and dangerous business practices of pharmacy benefit managers, or PBMs ("AGs want high court to review PBM case," June 12). In the article, the Pharmaceutical Care Management Association (PCMA) spokesperson proclaimed, "Requiring plan sponsors to include unsafe or inefficient pharmacies in their provider networks, and forbidding health plans from using common cost-containment tools like preferred networks, will increase prescription drug costs for plans and patients." The association does not regulate or decide which pharmacies are safe or unsafe. Pharmacies are regulated by state Boards of Pharmacy, which will shut them down if they are deemed "unsafe."


Regarding the PBMs having to include "inefficient" pharmacies in their networks: Of the 521 independent community pharmacies that existed in Minnesota in 2002, nearly 80% of these dedicated entrepreneurs providing health care services to their communities were apparently "inefficient" — only around 120 are left. It is difficult to be efficient when the drug manufacturer/wholesaler is controlling what you pay and the PBMs are controlling what you get paid.


The net effect is that community pharmacies are losing money on approximately 50% of the prescriptions they dispense. The net winners of this game are the PBMs, which are extracting money from the manufacturers, the wholesalers, the insurance companies, government contracts and community and health system pharmacies. The net losers: You and me who are paying more (though premiums and copays) for less accessibility to prescription, immunization and pharmacy care services.


Jason Varin, Eden Prairie

The writer is a pharmacist.

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