Creighton University researchers have found that some pharmacy benefit managers--the companies behind the cards most Americans use to fill prescriptions--are making impressive profits on generic drugs. These drugs are usually promoted as saving a company or employee money if one chooses a generic drug instead of a brand-name drug.
Prescription drugs remain the fastest-growing component of America's soaring $1.1 trillion health care bill. It's a bill with hidden costs. And it's a bill consumers pay, either out-of-pocket in direct payments or in co-pays and premiums, or out of the pool of wages and benefits set aside by one's employer.
The challenges to prescription benefit cost control is at the level of pharmacy benefit managers, according to a pilot research study conducted by Creighton University Medical Center researchers Robert I. Garis, R.P., M.B.A, Ph.D, and Bartholomew E. Clark, R.P., Ph. D.
The study conducted by Drs. Garis and Clark reviews pharmacy benefit managers (PBMs), which are middlemen between a corporation buying pharmacy benefit plans and pharmacies that supply the prescription goods to the corporation's employees. PBMs are commonly called Pharmacy Card Companies. While some PBMs serve a valuable function and provide great value, other PBMs create a price spread that doesn't benefit corporations, their employees or America's overall health care bill.
For example, according to researchers Garis and Clark, for the generic version of the stomach medication Zantac, the PBM billed the corporation over $200 and paid the pharmacy $15 for the same prescription. Another example is the generic form of the blood pressure medication Tenormin, the PBM billed the corporation $80 and paid the pharmacy $7 for the same transaction.
"With our study, we want to raise awareness throughout corporate America that they should review their pharmacy benefit plans. They could save substantial dollars that can be passed onto employees if they knew how to better evaluate prescription drug plans," said Garis. "There needs to be more accountability among some PBMs who are out of line. This is an area of health care where we can generate some significant savings. Pharmacy can be part of the solution not the problem in controlling America's health care bill."
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