Improved Regulation Needed to Address Lack of PBM Transparency

Ron Lanton III, Esq., executive director and senior counsel for Frier Levitt Government Affairs, discusses the need for increased pharmacy benefit manager regulation on a federal level. 


I think we all would love to have increased pharmacy benefit manager regulation because number 1: there’s no oversight. There’s no federal oversight and there’s really no state oversight. When it comes to the states, it’s more of a patchwork. It really depends on if the Department of Insurance wants to take the lead, we’ve also had some states that have entertained the board of pharmacy taking the lead. So it really depends on how active or at least consumer-engaged the state is, that will depend on how hands on the state wants to be in far of overseeing that. The federal oversight has really gotten me. There’s really never been an answer about why there’s never been a federal overseer, so I think that’s definitely some work to do on that. But, you know, we need it because there is no transparency. Pharmacy benefit managers are running amok, they can do whatever they want. There’s no transparency on rebates, there’s no transparency on DIR, there’s just nothing. And it’s really hurting a lot of the pharmacies. So I think rather than saying hey Congress, you need to pick market winners and losers, which we know they won’t, we’re just saying level the playing field.

Most Popular

Related Articles

Operating a specialty pharmacy is a great benefit to health systems that adopt it early, while those who wait are going to face higher risks and have a lower probability of success.
A data-centric approach is vital for patients with complex conditions, particularly in determining what has worked well and anticipating what medical or pharmacy care is required for effective outcomes in the future.
The shift from fee-based, volume-driven care to value-based, patient-centered care and the growth of specialty pharmaceuticals are propelling us all into uncharted territory, no matter what role you play in health care.
Company Profile >
Industry Guide >
Market News >
Peer Exchange >
Conferences >
Subscribe >
Specialty Times Resources
About Us
Contact Us
Terms & Conditions
MJH Associates >
Pharmacy Times
American Journal of Managed Care
MD Magazine
Targeted Oncology
Physicians' Education Resource
Pharmacy & Healthcare Communications, LLC
2 Clarke Drive
Suite 100
Cranbury, NJ 08512
P: 609-716-7777
F: 609-716-4747

Copyright Specialty Pharmacy Times 2006-2018
Pharmacy & Healthcare Communications, LLC. All Rights Reserved.