Credit: Commonwealth Media Services

PA Auditor General To Review Prescription Drug Pricing

Eugene DePasquale Wants More Transparency From Pharmacy Benefit Managers

June 14, 2018 - 10:26 am

HARRISBURG (Newsradio 1020 KDKA) - Pennsylvania Auditor General Eugene DePasquale says he's opening an investigation into pharmacy benefit managers, who determine which prescription drugs are covered by insurance as well as drug reimbursement rates.

DePasquale says one of the main things he's investigating is how the state spends on pharmacy benefit managers and how do they bill insurance companies for a drug.

“States across the country are struggling with this issue because there currently is no state or federal oversight of these pharmacy benefit managers,” DePasquale said during a news conference at the Capitol . “Taxpayers and businesses deserve more transparency in the pricing of prescription reimbursements than is currently required, and I want to fix that. Said DePasquale.

DePasquale plans on holding several regional hearings to speak with pharmacists and PBM's to make sure residents are getting a fair price for prescription medication.

“My office is in the best position to review the impact PBMs have on hundreds of thousands of Pennsylvanians ,” DePasquale said. DePasquale said his team will look into these questions:

• How much does the state spend on pharmacy benefit managers.

• How do pharmacy benefit managers bill insurance companies for a drug,

• How do PBMs determine the drug reimbursement rate for pharmacies and are those rates consistent across different types of pharmacies.

• Do PBMs pass along savings from rebates and price cuts they get from drug manufacturers.

• Why is drug pricing information kept private when taxpayers are footing the bill.

• What the Department of Human Services is doing about contracts that involve pharmacy benefit managers.

• Are any Pennsylvania pharmacies are subject to gag orders, and How can Pennsylvania can ensure transparency and fairness in pharmacy pricing for consumers.

“I want to make sure that consumers always know how to receive the best price possible for the prescriptions they need,” DePasquale said

He adds many PBM's may be undercutting reimbursement rates, putting many small pharmacies out if business.

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