This week, the Federal Trade Commission released a report highlighting the impact of drug middlemen on prescription drug costs in the United States.
The report reveals that six of the largest pharmacy benefit managers control 95% of the prescriptions filled in the U.S. These third-party companies negotiate prices between insurance companies and pharmacies, often resulting in higher out-of-pocket expenses for patients.
“One in three people in this country cannot afford their prescription drugs,” said Merith Basey, executive director of Patients for Affordable Drugs. She emphasized the lack of transparency in these negotiations and the need for clarity in the process.
The FTC report emphasizes that pharmacy benefit managers hold significant power in determining patients’ access to and affordability of prescription drugs, leading to adverse effects such as medication rationing or skipping doses due to high costs.
The report also features personal stories, like Giovanna Burno’s experience with high monthly medication costs and Kevin Trager’s struggle with insulin dosing changes mandated by his insurance.
According to the report, the market for pharmacy benefit management services has become highly concentrated, with the largest PBMs integrated with major health insurers and pharmacies, further impacting drug prices and availability.
Scripps News contacted the Pharmaceutical Care Management Association for comment on the FTC report but has not received a response yet.
Further information from Congress indicates that Americans pay more for medications compared to other countries, reflecting the financial burden faced by individuals like Kris Garcia, who has to manage costly treatments for his blood conditions.
The FTC’s report also highlights challenges in obtaining necessary information from some PBMs, aiming to ensure compliance with regulations to protect consumers’ interests.
