PBM WATCH
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The lack of regulation in the PBM market has allowed the major PBMs to form plans to use the PBMs’ own mail-order and specialty pharmacies.  Substantial conflicts of interest arise when a PBM owns its own pharmacy operations.  Its incentives shift from negotiating the lowest cost method of drug distribution to driving profits from its own pharmacy operations, and thereby effectively forcing payors and consumers into using the PBM-owned mail order, specialty, or retail pharmacies.  

Consumers strongly prefer dealing with a community pharmacist and especially for specialty pharmaceuticals, the pharmacist provides invaluable counseling and patient monitoring.  

In addition, PBM owned mail orders often increase utilization and costs by dispensing unnecessary drugs.  

The conflict of interest denies consumers access to quality health care and increases the cost of overall health care to plans and consumers.
  • Home
  • The PBM Problem
    • Problems in the Market
    • How PBMs Affect Cost
    • Conflicts of Interest
    • Our Goals
  • Resources
    • CEA February 2018 Report-PBMs
    • PBM Role in the Healthcare Market Place
    • CVS and Aetna Merger
    • PBM Litigation Overview
    • Academic Articles
    • Testimonies and Letters
    • Any Willing Provider Laws >
      • State AWP Statutes
      • Any Willing Provider Cases
    • Industry White Papers
    • Dealing with PBMs
    • Express Scripts-Medco Merger >
      • Stakeholder opposition to Express Scripts Medco
    • DIR Fees >
      • DIR Fee Legislation
      • News on DIR Fees
    • MAC Information Center >
      • Current State MAC Legislation
      • Pending State MAC Legislation 2014
      • State MAC Initiatives
      • MAC Articles and News
    • PBM Legislation
  • Part D Reform
    • Stakeholder Comments
    • Rebates
    • Congressional Letters
  • News Room
  • Take Action
    • Contact a Legislator
    • Consumer Complaints
  • Links
  • Contact Us
    • Tell Us What You Think!
    • About Us
  • CVS and Aetna Merger