Pharmacy Benefit Managers harm patients

THE PROBLEM

PBMs are costing Californians

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In a recent study, patients paid $135 million over the cost of their drugs

PBMs keep this money for their own profit. PBMs involve themselves in all aspects of a prescription drug program, from negotiating drug prices with manufacturers, to demanding rebates for medication placement on formularies, to contracting with health plans and pharmacies.

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The three largest PBMs cover more than 180 million lives

Roughly 78% of the market. With this market influence, employers, government entities and other purchasers of healthcare must have transparency into PBM practices, many of which add hidden costs that lead to higher healthcare prices.

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PBMs largely operate in the shadows of the healthcare system

PBMs escape the scrutiny of government regulation and licensure. The original intent of PBMs was to assist insurers and employers in managing prescription drug benefit programs acting as third party administrators. But PBMs have evolved into much more complex organizations including acquiring or establishing their own specialty, mail-order and community pharmacies.

TAKE ACTION

What We're Doing

We are shining the light on PBMs

In 2018, we started our fight against PBMs by passing legislation here in California to increase transparency and hold PBMs accountable. AB 315 was a critical first step in bringing to light how PBMs contribute to the rising costs in healthcare. Thanks to Asm. Jim Wood’s leadership, PBMs are now required to register with the California Department of Managed Health Care, disclose cost information and potential conflicts of interest.

But we’re just getting started. We must fight for even greater transparency and policies that will level the playing field and prevent PBMs from profiting off patients with hidden costs.

Join our coalition today to take action against PBMs.