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Confusing New PBM Drug Pricing Terms Leave Payors Unsure of Next Steps
Date:8/11/2009

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Clauses in the PBM agreements are being enacted to protect margins, due to the expected behavior of the PBM pharmacy networks who will demand renegotiation of the discounts provided to PBMs that maintain current drug cost pricing spread margins or pricing guarantees.

Many executives assume that their agreement is immune to any adjustments since they have negotiated their PBM agreement on a fixed cycle, however, the fine print in a number of these contracts opens the door to negotiations. Benefit and pharmacy directors will no doubt be surprised by the receipt of new pricing terms that on the surface look very inferior to current terms in place, or are completely unfamiliar, according to Shelley.

Basically the pharmacies and the PBMs are protecting themselves from loss of any margin despite the fact that the settlement was created to rectify an inequity to payors of drug cost overpayment.

In fact, PBMs are aggressively renegotiating their contracts and offering internally derived solutions to this pricing dilemma, but none have stated that there will be savings to the payors resulting from a roll-back in drug costs. "Many PBMs are moving quickly on the client side, but have offered little detail to their clients regarding whether the PBM's network is really mandating the reduction in discounts. We understand PBMs are the pricing middlemen between payors and pharmacies, but have all the 45,000+ pharmacies nationwide come back to the PBMs and renegotiated new agreements with lower discounts? If not, a PBM is actually benefiting immensely by these actions, by lowering discounts to clients but not to pharmacies," says Rucinski.

2) Validating the Appropriate Next Step to Secure Best Financial Agreement

The majority of payors will be faced with complex decisions with new and unfamiliar pricing terminology adding to
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SOURCE TRICAST, Inc.
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