Lawmakers urged to crack down on drug benefit managers


Pennsylvania’s fiscal watchdog is urging state lawmakers to rein in the companies that decide which prescription drugs are covered by health insurance plans.

Auditor General Eugene DePasquale testified Wednesday before the House Health Committee about his special reports on the business practices of pharmacy benefit managers.

DePasquale said pharmacy benefit managers receive state and federal funding but are allowed to operate in secrecy. The companies also help to set reimbursement rates for pharmacies.

“Pennsylvanians are paying more for prescription drugs than they should because of an opaque system that lacks transparency, is squeezing out competition, and billions of dollars in Pennsylvania taxpayer dollars are at stake with no oversight and accountability,” DePasquale said.

DePasquale recommended legislation that would increase transparency, allow the state to review contracts, and ban “gag rules” that prevent pharmacies from voluntarily telling patients when they can save money on medication.

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