Premier recommends improved business practices for PBMs

May 27, 2022

Premier responded to a request for information (RFI) from the Federal Trade Commission (FTC) on how business practices of pharmacy benefit managers (PBMs) affect patients, doctors, employers, pharmacies and other businesses in the prescription drug space, according to their press release.

In its response, Premier describes how a host of PBM practices result in negative consequences for patients and stifle competition. These harmful practices include rebates and formulary placements, PBM preferred products, “white bagging,” pharmacy price concessions (direct and indirect remuneration (DIR)) and discriminatory 340B pricing. Premier urges the FTC to investigate the practices of PBMs and recommends that PBM transparency standards:

·        Be created to specifically meet the needs of the PBM business model;

·         Require PBMs to report all fees, rebates, discounts, etc. at least annually, including what percentage of fees are passed through;

·         Require PBMs to disclose differential reimbursement for PBM-owned or PBM-affiliated pharmacies;

·         Require PBMs to disclose how pharmacy reimbursement is calculated, maintained, updated, and where to find relief when paid below actual acquisition costs; and Ensure state oversight of Medicaid Managed Care Programs to deter tactics such as spread pricing.

Premier release