In a recent comment, J criticized me for being too negative about Caremark. So I’ve tried to find something to balance that negativity and did come up with this article this morning. Congratulations to the employees manning the phones. It’s not an easy job and I can say that I’ve honestly never had a problem with anyone I’ve spoken to on the phone, so for that Caremark deserves a thumbs-up.
On the other side of things, however, we have this piece of news about Caremark and other PBMs:
Pharmacy benefit managers, hired by employers to manage prescription drug purchasing, have long been criticized for not passing on to clients the rebates they receive from drug manufacturers.
After all, PBMs are in business because they save their clients money.
Recently, many PBMs have agreed to pass along rebates on brand-name drugs to customers. Yet such gains are too little too late, according to some health care benefits experts.
“I think those who have been caught up in the rebate game are very shortsighted,” says Keith Bruhnsen, assistant director of staff benefits at the University of Michigan. Bruhnsen led the university’s effort to do away with PBMs and manage its drug spending.
Whether you agree or disagree with J’s points about how I feel about Caremark, I think it’s fair to say that the entire system is broken and in need of repair.
It’s unfathomable to me that the premium rates for health insurance rose at twice the rate of inflation last year while the average benefits and coverage actually dropped. If the study had factored in the lowered limits and higher deductibles on health insurance benefits the rate of increase would likely have been five or six times the rate of inflation.
Finally, I’m wondering how PBMs and health insurers can possibly provide data to the FDA for studies of the safety of ADHD medications when they limit which medications patients can use and therefore have incomplete data.
In one week articles about the FDA’s follow up on approved medications, PBM rebates, and outrageous increases in the cost of health insurance. Profits for the third quarter for these companies will be announced soon. I somehow doubt that any of them will have dropped.
The system is broken. The question is how to fix it?
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