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ADVI Expert Discusses The Evolving Narrative Around Price-Gouging and Evidence-based, Market-Driven Tools as it Relates to PBMs with AIS Health

ADVI Health expert Lindsay Bealor Greenleaf from the Federal and State Policy team sat down with AIS Health to discuss AHIP’s new advertising campaign that accuses the pharmaceutical industry of deflecting blame for its “price-gouging” practices and undermining the “evidence-based, market-driven tools” that health insurers use to keep drug costs in check and how the campaign omits or overlooks pharmacy benefit managers (PBMs).

She noted that the momentum is there when it comes to PBM reforms. PBMs and health plans have benefited historically from a really complicated supply chain and lack of transparency in the system that has allowed for manufacturers to be solely targeted up until this point. She cites the fact that the Inflation Reduction Act (IRA) mainly left PBMs alone while including measures that were bitterly opposed by drugmakers, such as imposing penalties when drug prices rise faster than inflation and allowing Medicare to negotiate the price of select medications. Now that you have key Democrats on record being this critical of PBMs, it’s going to be really hard to unwind that. Once members of Congress dive into issues like this, their eyes are wide open.

You can read more on this story in AIS Health.

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