JEFFERSON CITY, Mo. — The Missouri Pharmacy Association believes the state could be doing more to make prescription medications more affordable.
They are supporting legislation that would regulate groups known as Pharmacy Benefit Managers (PBM).
PBMs manage prescription benefits for health insurers. The idea is they can use their size to purchase medicine at discounted prices.
Some critics believe the cost savings or rebates PBM’s receive should be passed directly to the consumers. They say that’s what senate bill 971 would do and also want to end what they call a practice of directing patients to specialty or mail-order prescriptions.
“It feels awful to have to tell a patient that they can’t get the medication they’ve been on the last 10 years managing their disease state very well because their PDM has decided that is not on their formulary, which the formulary list is the list of prescriptions, medicines they say they will cover,” said Erica Crane, pharmacist.
PBM’s maintain if a doctor deems medicine necessary, there is a path to receiving the medicine. The mother of a liver transplant patient, Loretta Boesing, said a PBM put her son’s life at risk.
“A mail-order pharmacy without question shipped my child’s life-saving transplant medication, and we went with oral transplant medications on a 102-degree day without any protection,” Boesing said.
PBM supporters maintain mail orders that can have a higher rate of accuracy than pharmacy fills. The bill’s sponsor is a retired pharmacist who has concerns over communities losing their local pharmacy.
“I want to see our pharmacy profession to be able to maintain the vitality that it has and be able to serve their patients,” said Senator David Sater (R-Cassville).
The PBM industry reports the number of independent pharmacies has grown over the past decade.