PBMs are #OnYourRxSide, Lowering Prescription Costs
In an opinion issued in early December the U.S. Supreme Court upheld an Arkansas law regulating the maximum allowable cost (MAC) lists that Pharmacy Benefit Managers (PBMs) use to keep prescription drug costs low for employers and employees. By allowing the state law to stand, the Court puts at risk an important tool used to incentivize pharmacies to stock the most affordable prescription drug options — and at the same time lets pharmacies refuse to serve patients if they feel they will not be paid enough on a particular generic drug.
Yet, there is some hope for employers, benefits providers, and hard-working Americans who deserve quality, affordable coverage. The Court’s decision simply upholds the Arkansas law as a type of “rate regulation,” which traditionally states have always had the power to enforce.
The ruling, however, does not allow unfettered state power to restrict the types of tools employers—through PBMs—can use to provide robust prescription drug benefits at a reasonable cost.
PBMs will continue working with employers and others in the health care supply chain to make prescription drugs more affordable for hard-working Americans by reducing costs from both drug manufacturers and pharmacies. PBMs have been a leader in decreasing cost and increasing accessibility during the 2020 COVID-19 pandemic, and they will continue to lead as the nation tackles the tough road back to health and economic stability in 2021.
Learn more about the role PBMs play in lowering the cost of prescription drugs and how they are always #OnYourRxSide.
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Pharmacy benefit managers (PBMs) are your advocates in the health care system, working to lower out-of-control prescription drug costs for patients across the country.