You may have visited your pharmacy for months and paid a $5 copay for your medication. Then one dreadful day, you discover that your copay has jumped to $50. What caused this jump in price? You’re not alone. 79% of Americans believe that they’re spending too much money on medications. And, they’re unaware of why drugs sometimes have a sudden increase in price. What do you do when your copay shoots up? Many people skip doses of their medications or stop treatment altogether. This can have a lasting negative impact on your health and your wallet.
In 2020, traditional Pharmacy Benefit Managers (PBMs) aren’t transparent about costs. You might think how can the PBMs get away with this. PBMs are the middlemen between the pharmaceutical industry and your pharmacy. They have minimal oversight by our government, so it’s easier for them to cut corners and act out of greed. Like you, many other Americans are unaware of their crafty tactics. Today, different states across the country are making moves towards drug pricing transparency.
In 2015, eleven states put in place drug pricing transparency laws. Under these laws, PBMs must report all drug price increases and give reasons for the increase. These laws hope to incentivize the PBMs to lower drug prices. You can find a summary of the new laws here.
The three major trends shaping the drug pricing transparency laws are:
The most common laws want drug companies to provide detailed drug pricing information. In particular, Oregon wants companies to report to their specific government agency. While, states like California, want to receive a heads up on any drug price changes. Trigger events occur when the cost of drugs reaches above a certain dollar amount. Or, if the cost has been trending upward over a year.
Wait, there’s more. Several states like Connecticut and Vermont have a board come up with a list of drugs they spend the most money on. They then track where the costs have significantly increased over 1-5 years. Later, the board petitions the drug companies to provide more information on drug pricing. In 2019, Nevada covered classes of diabetic drugs like insulin and metformin-combo drugs. But since included asthma-related drugs into the mix. Additional laws require PBMs to disclose information about their deals with pharma and insurers.
How is Pharma responding to these changes? It turns out that the drug industry hasn’t complied with these new changes. Priscilla VanderVeer, a spokeswoman for Pharmaceuticals Research and Manufacturers of America, spoke with Steve Findlay, a Kaiser Health News reporter.“We agree that what consumers now pay for drugs out-of-pocket is a serious problem,” said VanderVeer. “Many states have passed bills that look good on paper, but we don’t believe it will save consumers money.”
While there’s a back and forth going on amongst states and the drug industry -- lack of drug pricing transparency continues to have disastrous effects on real people each day. Many companies claim that they can’t report on drug cost information because it goes against federal law. States have gained some traction. New York has negotiated rates with over 30 drug companies and saved 85 million dollars. Nevada and California have fined companies that failed to follow their state law. There’s a lot of work to do, but you don’t have to go at this alone.
Lucky for you, Scriptly Rx only works with transparent PBMs. We want to help you save on the medications you need the most. The best thing is, our medication discounts contain no hidden fees, so you’ll spend less money. We want a future where drug pricing transparency is the norm rather than the exception. Check out how much you can save here.
Note about the author: Brittany DeJohnette, PharmD, is a pharmacist and health copywriter. She enjoys creating tasteful and compelling content in the health and digital marketing space. She's written for Thrive Global, TheHealthcareGuys, and more. As a wellness advocate, Brittany revels in the moments when she helps others make informed decisions about their health. Visit her here: Healthful Content. Connect on: LinkedIn.
2019 was quite the year! People were kicking off bottle caps, Game of Thrones came to an end and baby Yoda became the cutest baby any of us had ever seen; however, one of the most important events of 2019 came without any critical acclaim. I know what you’re asking yourself right now, “What could have possibly happened in 2019 that was more important than Baby Yoda?” How about the fact that 2019 marked the 14th consecutive year that drug prices rose faster than inflation.