Manatt Health Partner Ross Margulies was quoted in a CNN article on how the funding deal in the federal government’s recent continuing resolution will impact pharmacy benefit managers (PBMs).
The agreement includes a package of reforms for PBMs, requiring them to—among other things—pass along all rebates to the health plan sponsors in the commercial insurance market, and would essentially eliminate “spread pricing,” wherein the PBMs withhold part of the payment they receive for drugs from pharmacies, in Medicaid.
“The effort aims to increase transparency and change the industry’s compensation structure,” said Margulies. “The concern until now has been that PBMs may have the incentive to prefer higher-cost drugs since they can negotiate larger rebates on them.”
Read the full CNN article here.