FTC Launches Probe of PBM Policies (Part 1)
Drug Benefit Trends
But that's just the beginning of what may be a long-running investigation that could expand into "a more detailed empirical study," according to the FTC, and possibly legal action against some PBMs.
Commission staffers say that a previous study found evidence suggesting that on all 3 key issues, PBMs that own mail-order facilities show different preferences than those that do not. The current probe will try to expand on that study by sifting through such information as how the average prices paid by plan enrollees vary by dispensing channel, whether demographics of patients vary by dispensing channel, and whether there are differences in the most-dispensed drugs by dispensing channel. The FTC wants details on pass-throughs of rebates from pharmaceutical manufacturers to plan sponsors and is asking the dispensing pharmacies how often an alternative drug is substituted for the one originally prescribed by the physician, and why. The agency is also asking for any information in PBM company files relating to "strategies and business practices for lowering the net price" paid for pharmaceutical products.
The study was ordered by US Congress last year as part of the law adding a prescription drug benefit to Medicare.
Drug Benefit Trends 16(5):236-239, 2004.
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