Latest Investigations Indicate PBMs Utilize Several Tactics to Generate Revenue
COLUMBUS, OHIO – The PBM Accountability Project of Ohio, a coalition of labor, business, healthcare providers, patient advocates, and other stakeholder groups, commends the efforts of the Ohio Joint Medicaid Oversight Committee and the Ohio Department of Medicaid for their continued efforts to hold PBMs accountable to taxpayers and to Medicaid beneficiaries. The coalition today released the following statement:
“Recent revelations from Ohio Department of Medicaid have exposed how PBMs carry on complex pricing schemes that continue the illegal practice of collecting ‘clawbacks’ from pharmacies and inflate prescription drug costs, thus distorting how Medicaid can accurately know and cover the costs of drug transactions for beneficiaries. The PBM Accountability Project of Ohio recognizes that significant work is still required to understand and reform the ways PBMs serve state-funded systems such as Ohio Medicaid. We are committed to helping our state leaders address the many ways PBMs profit off the backs of Ohioans.”
“Clawbacks” are one of many tactics PBMs utilize to increase their profits at the expense of Ohio taxpayers and patients. A recent report highlighted in the Columbus Dispatch analyzes the rapidly evolving revenue streams of PBMs as they work to respond to increased scrutiny of their secretive business practices. The report compiled data into a comprehensive analysis to better understand PBM business models, revenue sources, hidden profits and potential reforms.