NCPA president says PBMs have too much power

National Community Pharmacist Association (NCPA) President Bradley Arthur provided testimony Nov. 17 on the dominating power that large pharmacy benefit management (PBM) corporations have on the pharmaceutical marketplace.

At the hearing of the House Judiciary Committee Subcommittee on Regulatory Reform, Commercial and Antitrust Law, Arthur discussed how choice is limited with regards to large-scale prescription drug plans as the majority of patients whose benefits are managed by PBMS are covered by three corporations.

Arthur pointed out that small community pharmacies are at a disadvantage because the contracts PBM corporations offer them would jeopardize their financial success and pharmacists at community pharmacies can't make informed business decisions due to the unknown criteria used by PBMs to determine multi-source generic drug maximum allowable cost (MAC) reimbursements.

Relating to generics, Arthur said that PBMs' failure to update MAC reimbursements in the wake of pharmacies paying high prices to acquire generic drugs leads to huge losses.

Arthur also discussed how PBM corporations have mostly avoided federal regulations and have a number of conflicts of interest as they own both mail order and specialty pharmacies.

As the co-owner of BlackRock Pharmacy and Brighton-Eggert Pharmacy in New York, Arthur said small community pharmacies like his continuously have to deal "with the impact of PBMs' disproportionate market power."

“I can tell you that as a small business owner and healthcare provider, the current situation and overall business climate that exists in which market power is increasingly concentrated in an ever-shrinking number of corporations – makes me apprehensive about what is around the bend,” Arthur said.