“DOSE OF REALITY”  Calling Big Pharma’s Bluff On PBMs: Part I

Apr 4, 2019

Big Pharma has tried to evade culpability for the crisis of rising prescription drug prices by pointing a finger at pharmacy benefit managers (PBMs).  As the U.S. Senate Committee on Finance prepares to hear from the executives of five PBMs on April 9, it’s time to debunk Big Pharma’s bluffs.  PBMs serve an essential role in the prescription drug distribution chain and work on behalf of payers and consumers to reduce prescription drug costs, increase convenience and improve safety.

Ahead of the hearing, we’re setting the record straight on the essential role PBMs play in negotiating savings for patients by calling out Big Pharma’s suspect claims and pushing back on the proposed Rebate Rule’s false promises.

Today, we’re tackling Big Pharma’s claims that PBMs are “unnecessary middlemen.“


PBMs Are Middlemen Who Don’t Add Value To The System.


266 Million Americans Rely On PBMs To Lower The Annual Cost Of Prescription Drugs By Up To 50 Percent.

  • PBMs Save Customers And Patients Between 40 And 50 Percent On Their Annual Prescription Drug Costs. (“The Return On Investment [ROI] On PBM Services,” Visante, November 2016)
  • For Every Dollar Invested In PBMs’ Services, They Produce $6 In Savings. (“The Return On Investment [ROI] On PBM Services,” Visante, November 2016)
  • PBMs Will Save American Patients $2 Trillion Over The Next Decade. (“The Facts About Pharmacy Benefit Managers And Rebates,” Express Scripts, Accessed 3/29/19)
  • PBMs Are Projected To Save The Health Care System $654 Billion Over The Next Decade. (“Pharmacy Benefit Managers,” Express Scripts, Accessed 3/28/19)

Though They Now Cast Blame On PBMs, Big Pharma Once Praised Them and Even Solicit Their Services.  

  • All Seven Drug Makers That Appeared Before The Senate Finance Committee In February Work With PBMs To Manage Their Employee Prescription Drug Programs. (Bob Herman, “Pharma Companies Hire Drug Pricing Middlemen, Too,” Axios, 3/7/19)
  • PhRMA President Stephen Ubl: PBMs’ “Private Negotiation Helps Keep Costs Low For Both Beneficiaries And Taxpayers.” “Government regulation in the Medicare prescription-drug program won’t save patients money.  That is because price negotiation already occurs effectively within the program.  Large, powerful Part D purchasers negotiate discounts and rebates directly with manufacturers, and according to the Government Accountability Office, this private negotiation helps keep costs low for both beneficiaries and taxpayers.” (Jonathan D. Rockoff, “How Do We Deal With Rising Drug Costs?,” The Wall Street Journal, 4/10/16)
  • Eli Lilly CEO Dave Ricks: “We Hire A PBM By The Way For Our Employee Benefits … To Negotiate Lower Drug Prices … That’s How The System Works; It’s A Marketplace And We’re For That.” “We hire a PBM by the way for our employee benefits – I provide insurance for 70,000 Americans who work for [Eli] Lilly or their beneficiaries and retirees – to negotiate lower drug prices.  That’s part of our system, and we’ve been working with ESI and other entities to make our products available.  That’s how the system works; it’s a marketplace and we’re for that.” (CBS, 5/8/17)

Stay tuned for our next blog tomorrow comparing challenging another one of Big Pharma’s deceptions.