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

Apr 7, 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.

Friday, we challenged the falsehood that eliminating rebates will bring down the cost of prescription drugs.

Today, we’re going toe-to-toe against the claim patients don’t benefit from the savings PBMs achieve.


Price Savings Secured By PBMs Aren’t Passed On To Patients.    


PBMs Pass The Vast Majority Of Rebates Onto Their Customers, Who Return Savings To Consumers And Patients By Way Of Lower Premiums And Reduced Cost Sharing.

  • PBMs Pass Back 90 Percent Of Negotiated Rebates. (“The Facts About Pharmacy Benefit Managers And Rebates,” Express Scripts, Accessed 3/29/19)
  • Two Of The Largest PBMs – Express Scripts And CVS Return Between 90 And 98 Percent Of Rebates To The Customer. (“Let’s Talk About Rebates,” Express Scripts, 5/15/18) (“The Myth About Drug Rebates And List Prices,” CVS Health, Accessed 3/27/19)
  • Experts At Both The Federal Trade Commission And The Department Of Justice Agree That The Rebates PBMs Negotiate In Confidence Produce More Competition And Lower Costs For Plan Sponsors And Patients. (“The Facts About Pharmacy Benefit Managers And Rebates,” Express Scripts, Accessed 3/29/19)
  • In 2017, Medicare Part D Premiums Would Have Been 45 Percent Higher Without PBM-Negotiated Rebates. (Randall Fitzpatrick & Chris Carlson, “Premium Impact Of Removing Manufacturer Rebates From The Medicare Part D Program,” Oliver Wyman, 7/6/18)

Click through to catch up on Calling Big Pharma’s Bluff On PBMs: Part I HERE and Part II HERE.