One of the U.S.’s biggest drugstore chains, CVS Pharmacy, recently conducted a survey that revealed more than 80 percent of Americans are concerned about the rising costs of prescription drugs in this country.
Truth be told, that’s a fair concern. The U.S. Government Accountability Office recently reported that people are spending twice as much on prescription drugs as they were 30 years ago, all the while pharmaceutical sales and profit margins have ballooned.
From 2017 to 2018, drug prices were expected to increase by nearly 8 percent, according to Vizient’s drug pricing forecast–and that was largely due to “the surging prices of branded, specialty medications.”
In an interview with Modern Healthcare, Scott Knoer, Chief Pharmacy Officer at Cleveland Clinic, said, “Drug companies raise prices far exceeding inflation because they can.”
Whether or not your employees understand why pharmaceutical costs are rising, they’re well aware that they are, and thus why it’s a worrisome issue for most Americans.
Singled out as drivers of rising drug costs are the PBMs–Pharmacy Benefit Managers. In the 1980s, PBMs were created to help streamline the pharmacy benefit. While this initially started as a way to save money–as competitive pharmaceuticals offered rebates to be part of a PBM’s preferred formularies–the evolution of PBMs now allows expensive drugs to be preferred over cheaper alternatives (or better working alternatives), based on financial incentives.
Basically, when it comes to making sure employees receive the best-working, lowest-cost option drugs, companies have to take the middle man’s word for it. And while PBMs were designed to save companies money, there are plenty of examples that show they’re actually making drug prices worse.
At a time where the pseudo-transparency of the pharmaceutical world results in high prices, backroom deals and rampant overcharging and PBMs pocketing the difference, it’s clear that consumers are ready for substantive change.
Using the Health Rosetta’s dedication to transparency and control over PBM services, Captiva Benefit Solutions ensures members have relevant information to make informed choices, that clinical decisions are based solely on efficacy and actual cost, and that decisions work on behalf of the purchaser’s best interests.
The corporate world is starting to take notice, too. The aforementioned CVS Pharmacy is responding to the concerns expressed in its survey by rolling out the new Rx Savings Finder program, which will “show pharmacy teams if a prescription on a beneficiary’s formulary is the lowest cost option and if there are cheaper alternatives available,” according to Thomas Beaton of HealthPayer Intelligence. “Rx Savings Finder users also have access to information that indicates when a 90-day prescription is more affordable than a 30-day prescription.”
It’s time to have a Pharmacy Benefits Management system that is earning its pay by showing actual results–reducing the cost of prescription drugs for companies and employees.