Letter to the editor: PBMs should be held accountable

Thank you for publishing the article “Pharmacists open up to state Senate committee about financial struggles at hearing” (April 15, TribLive), which explains how pharmacy benefit managers (PBMs) are pushing small independent pharmacies out of business.

PBMs claim to lower prescription drug costs for patients, but in fact they are responsible for inflating the price of prescription drugs. I consider PBMs shady middlemen engaged in a legalized bribery scheme. They are hired by insurance companies to handle all things medication, drug prices, co-pays and rebates.

It is with the rebates where legalized bribery comes into play. The drug manufacturers’ rebates should be passed along to you, the customer, but instead go to the insurance companies’ PBMs.

A drug manufacturer uses a rebate as a kickback to an insurance company, so that an insurance company will place that manufacturer’s drugs on the insurance company’s formulary. A drug manufacturer then recoups the kickback cost by raising the drug price. This becomes a vicious cycle, with drug manufacturers increasing the prices of drugs to create bigger rebates to get their products favorably placed on formularies.

What happened with the rising cost of insulin and EpiPens illustrates this kickback problem.

Kickbacks have been illegal since the 1990s, but an exception was made for PBMs. It is time for PBMs to be held to the same standard as other industries under federal anti-kickback laws.

Pam Thompson

North Huntingdon