Pennsylvania Auditor Calls for Flat Fees for PBMs

Pennsylvania’s state auditor called on Tuesday for legislation requiring more transparency — and flat fees —for pharmacy benefit managers.

State Auditor General Eugene DePasquale issued a report urging increased transparency for PBMs’ business practices to help reduce Medicaid prescription costs. Pennsylvania’s taxpayers paid $2.86 billion to PBMs in 2017, a 100 percent increase from four years prior, he said.

The PBMs, he said, have acquired new responsibilities and duties such as determining which medications are covered and how much money pharmacies are reimbursed for them. But they continue to operate with minimal oversight and many have taken advantage of this lack of oversight to require pharmacists to sign restrictive “take-it-or-leave-it” contracts, the auditor’s office found.