Input Stories

Many companies are considering switching their pharmacy benefit managers, according to a new study (Axios, subscription). 
 
What’s going on: “More than half of 188 companies polled in September and October are considering a change to their PBM in one to three years, per a new survey from the National Alliance of Healthcare [Purchaser Coalitions].”  
 
The details: Companies considering a change said they want more transparent contracts and pricing. 

• Some 88% of those surveyed said they are now requiring or considering requiring a more thorough definition of “rebate” in their contracts with PBMs. 
• Approximately 80% are already using or are weighing using a value-based formulary instead of a rebate-driven one in the next few years. 
• About 86% said they have or are planning to have contracts with “full disclosure of all revenue streams with affiliated pharmacy-related entities.” 

Part of a pattern: The results of the NAHCP survey are in line with those of another organization, Business Group on Health, which found that a “third of its 40 members have begun to switch or are considering switching PBMs.” 

• These data also align with data from the NAM’s Q3 2024 Manufacturers’ Outlook Survey, which found that more than 72% of respondents supported congressional action to reduce health costs by reforming PBMs.  

Our view: “Employers’ calls for enhanced transparency and more fair pricing models illustrate the need for Congress to enact comprehensive PBM reform,” said NAM Vice President of Domestic Policy Charles Crain. “PBMs are increasing health care costs for manufacturers and manufacturing workers, and Congress must act to rein in these underregulated middlemen.” 

• The NAM extended a seven-figure ad campaign earlier this year, calling for reforms that increase transparency into PBMs and prevent them from pocketing savings intended for companies and employees.