PBMs' prescription-drug refill practices scrutinized

Linda Cahn, leader of the National Prescription Coverage Coalition, in a warning to chief financial officers and human resource executives, said on Tuesday that a recent study conducted by her firm reveals that many pharmacy benefit managers’ (PBMs) refill practices may be unnecessarily increasing prescription drug costs.

The study found that PBMs are dispensing many more pills from their subsidiary pharmacies than plan beneficiaries may be using, creating excessive and unnecessary prescription drug expenses.

"Our firm's recent investigation of PBM practices reflects that many PBMs have a standard practice of automatically dispensing refills, even if plan beneficiaries don't ask for them," Cahn said. "Making matters worse, the PBMs dispense each refill long before the plan beneficiary needs more pills, causing the plan beneficiaries to end up with scores of extra pills they don't need."

Cahn said the study found that PBMs carry out automatic refills in a variety of ways. Some PBMs seem to “sell” auto-refills to health plans, others are sending enrollment forms to plan beneficiaries and some implement the automatic-refill policy without consulting clients.

"Whatever the approach, it's inevitable that many people will receive refills who don't want or need them, leading to a lot of unused pills and unnecessary cost," Cahn said.

Cahn said all CFOs and human resource executives should investigate their PBMs' refill practices and end automatic refills to decrease costs and prevent extensive waste.

"There’s simply no excuse for the excessive dispensing of pills. Every PBM should be required to dispense refills wisely," Cahn said.

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Organizations in this story

National Prescription Coverage Coalition United State