The pharmaceutical supply chain is endlessly complicated and highly expensive for consumers.
From manufactures, to wholesalers, to pharmacies, PSAOs and PBMs, there are so many actors it is hard to figure out where reforms should begin.
In situations like this, starting with transparency is always best. There should be transparency into the full prescription drug supply chain.
House Bill 163 seeks to bring greater transparency to PBMs. While too narrow in scope, the increased transparency is a good thing.
Unfortunately, the bill is riddled with special interest poison pills that would make its passage devastating for North Carolina healthcare consumers.
First and foremost, it includes a new pharmacy tax that would increase costs by billions over the next decade.
This tax would be a windfall for major pharmacy chains but provide no added benefit to the consumer.
Second, it prohibits paying high-performing pharmacies more money based on higher quality and better outcomes.
Why would we ever want to disincentivize positive results?
And lastly, it eliminates an optional tool that many businesses use for price predictability on prescription drugs.
Taking away choices for how businesses can best plan and pay for their worker’s prescriptions is not a reform that will help anyone.
Transparency is important, especially with something as complex as the pharmaceutical supply chain.
Insurers and businesses hire PBMs to negotiate lower reimbursements. Pharmacies hire PSAOs to negotiate higher payments. Some of the biggest wholesales own PSAOs. And at the top, Big Pharma is still setting prices that no one can afford, then offering “rebates” that don’t even offset their price increases.
The whole setup is messy and in need of greater transparency.
Hopefully fresh efforts will look to shine a brighter light on the whole supply chain – and leave out the special interest giveaways that cost consumers.
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