The Long-Term Effect of Increasing PBM-Owned Specialty Pharmacies

Ron Lanton III, Esq., executive director and senior counsel for Frier Levitt Government Affairs, discusses how the growing number of PBM-owned specialty pharmacies could impact the pharmacy industry.

Transcript

I think there would be a significant long term impact if we continue to witness a lot more PBM-owned specialty pharmacies. The reason is, number 1, we talk a lot of about the lack of transparency anyway. So if they’re not telling you about DIR fees and they’re not telling you about rebates, imagine what else they’re not going to tell you about if they own the marketplace. Second, we see this as a conflict of interest, because you know how do you have all this information and then you’re taking up the market share and now you’re over here running the pharmacy, is that really in the patient’s best interest.

So I think that lack of transparency, lack of providers which is just not good for a marketplace, especially in rural areas where they rely on maybe 1 pharmacy for every 30 or 40 miles. So if you take that away from people, who are they going to go to and call? A lot of their PBM model is mail order, so picking up a phone is not the same as actually having a face-to-face interaction with your pharmacy, someone that’s been trusted to take care of your health care. Then obviously, adherence rates as well is something we’re worried about. Because there’s not that one-on-one connection, will people still take their medication? And that of course can drive up costs. So there’s a lot of questions with that, but I don’t think that’s a good idea and I don’t think that with the advocacy that we see NASP have at this point in time that that’s something we’re going to have to worry too much about. Like I said before, we do want to make sure there is transparency and that everyone knows where the foul lines are.