By Michael Ollove from Stateline, an initiative of The Pew Charitable Trusts
Buoyed by a major, unanimous U.S. Supreme Court ruling, some states are pressing ahead with efforts to rein in one of the most obscure — but also most potent — players in the prescription drug supply chain.
Pharmacy benefit managers, known as PBMs, are the companies that administer the prescription drug programs of health insurance plans. Since appearing in the 1980s, they have grown in influence.
They add layers and layers of complexity and costs as a middleman with no return for the state, the employer or the patients.
– Louisiana state Sen. Fred Mills
Policymakers say PBMs now play an outsize role in determining not only what medications patients can access but also how much patients, pharmacies and health plans pay for those drugs. Many critics insist PBMs are adding substantial costs to the health care system rather than saving it money….