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Study: without more transparency laws Pharmacy Benefit Managers can continue to drive prescriptions prices up

Twelve states across the country have filed lawsuits attempting to lessen the power of PBM’s, but Idaho is not among them
According to a study by data analysts at 46Brooklyn, one in four Americans say they can’t...
According to a study by data analysts at 46Brooklyn, one in four Americans say they can’t afford the medicines they need(WAFB)
Published: Sep. 15, 2021 at 5:46 PM MDT
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TWIN FALLS, Idaho (KMVT/KSVT) — Getting medicine from the pharmacy is as easy as getting a prescription and a quick transaction at the pick-up counter, but what goes into determining the costs at the window?

According to a study by data analysts at 46Brooklyn, one in four Americans say they can’t afford the medicines they need.

Behind the scenes, Pharmacy Benefit Managers (PBM) is probably a term many aren’t familiar with, but they have a massive impact on the amount you pay each time you pick up medicine from the pharmacy.

PBM’s began as middlemen, established to represent the buyer, and ensure the best prices possible.

Now, those same companies have nearly monopolized the business, with seventy-seven percent of all claims running through three Fortune 500 PBM companies.

“We have a broken dynamic that inherently allows middlemen to inflate the costs of medications without passing the savings on to consumers,” said Antonio Ciaccia of 46Brooklyn. “I haven’t seen any serious proposals recently that aim to address that phenomenon.”

Twelve states across the country have filed lawsuits attempting to lessen the power of PBM’s, but Idaho is not among them.

Until that changes, there are some ways you can be sure to protect yourself from unnecessarily high prices.

“You can use websites like Good RX to find cheaper medications or cheaper discounts on pharmacy prices,” Ciaccia said. “That is not a cure, by any stretch, but it is a mechanism that provides a band-aid on a broken system.”

Ciaccia tells KMVT without laws demanding more transparency from PBM’s, high drug prices will continue to be an issue and urges those concerned to speak to their representatives about the issue.

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