PBMs Dodge Bullet in New CMS Rule—But Remain in Washington’s Crosshairs

Pharmacy benefits managers breathed a sigh of relief last week when the Trump administration backed off proposals that would set Medicare drug prices based on the discounts offered by the benefits managers.

The Pharmaceutical Care Management Association (PCMA) welcomed the administration’s “thoughtful approach” and claimed that the negotiations between PBMs and pharmacies “generate significant savings for the federal government and beneficiaries.”

Although the PBMs dodged a bullet, they remain in Washington’s crosshairs. A rule to require discounts to be given directly to customers at the pharmacy counter is still pending and Congressional panels have taken turns bashing benefits managers as “middlemen” who inflate the cost of prescription drugs while adding little to the drug supply chain.