Washington can’t make prescriptions affordable the way PBMs can

Washington can’t make prescriptions affordable the way PBMs can

By Lisa Quarterman
CEO and Managing Partner

While Washington promotes old models to lower prescription drug costs, the PBM industry is working to identify effective paths to actual consumer savings.

As a pharmacy benefit management company, VativoRx is keenly aware of the need to simplify access to prescription drugs and to make them more affordable for everyone. 

And, while it’s good to see the president and Congress focusing on an issue that’s so important to all Americans, it’s unfortunate that such an opportunity to make real progress relies on doubling down on federal practices that might actually inadvertently drive up costs.

That’s why we agree with the Pharmaceutical Care Management Association (PCMA), PCMA recently noted in response to new federal programs in the president’s currently stalled Building Back Better package of legislation targeted at healthcare costs that, while well-meaning, these proposals would actually cost healthcare consumers more. 

This makes no sense to us, especially considering that there are already commonsense ideas on the table from PMCA:

“Adopting common-sense policies from PCMA’s the Critical Path Forward: Rx Policies to Reduce Patient Costs, Improve Access that end the anticompetitive practices of pharmaceutical manufacturers and enhance competition in the marketplace could achieve federal savings of $59.1 billion to $118.3 billion over 10 years.”

What’s involved in these proposals, dubbed The Critical Path Forward? Among them are:

  • Hold pharmaceutical manufacturers accountable for high prices on new and existing drugs
  • Promote generic and bio similar competition
  • Eliminate tax-deductibility of the drug advertising that you see everywhere

You can read the full report here. If you are in the business of making prescription drugs affordable to the most people possible, I recommend taking a closer look. It’s totally eye-opening.

VativoRx is committed to helping control the cost of prescription drugs by working with each individual client to identify opportunities for savings and by finding innovative ways to manage costs for both the client and the consumer. The positions of the PCMA are evidence of what we’ve been saying: PBMs can do better.

VativoRx Joins MHA: A New Chapter Begins

The world of healthcare is dynamic, continuously evolving with new challenges and opportunities. At VativoRx, we’ve always believed in the power of innovation, collaboration, and dedication to ensure that we provide the best rebate management solutions in the industry. Today, we’re thrilled to announce our latest milestone: VativoRx is now an official associate member of the Michigan Health & Hospital Association (MHA)!

Read More »

Unveiling the Future: Navigating the Evolving Landscape of 340B Rebates.

The 340B Drug Pricing Program, established in 1992, has been a crucial component of the healthcare system, dedicated to assisting eligible healthcare organizations in serving vulnerable patient populations by granting them access to discounted drugs. At the heart of this program are the 340B rebates, which enable qualifying entities such as safety-net hospitals, community health centers, and other eligible providers to acquire medications at significantly reduced prices.

Read More »
Martin Shields / Alamy Stock Photo

Humira – The End of an Era

In January 2023, the first biosimilar version of Humira, which is a widely used injectable drug for inflammatory diseases, was approved, marking the end of AbbVie’s two-decade market exclusivity. Humira is used to treat conditions like rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis, and it works by targeting certain proteins in the immune system.

Read More »

Biosimilars — Similar But Not Identical

You may have never heard of biosimilar drugs and that’s probably because they are not commonly prescribed in the United States even though they have been around for over 20 years. So, what are biosimilar drugs? A biosimilar drug is no different in terms of safety and effectiveness than a biologic product, also known as a reference product, and while highly similar it is not identical.

Read More »

Lower Cost Prescription Drugs from Canada, Is It Legal?

In the early 2000s, the FDA set up guidelines in the Regulatory Procedures Manual (RPM) that permitted prescription drugs to be imported from other countries if the patient met very strict guidelines. Just stating that the patient needed the drug due to cost savings was not a justification to obtain the drug.

Read More »