SPRINGFIELD, Ill. (WAND) — Illinois lawmakers know that the people responsible for negotiating drug discounts from manufacturers have actually increased prescription costs in recent years. Pharmacists and patients across the state are not giving up on changing the system to help lower prices.
The top three pharmacy benefit managers control 80% of the prescription volume in the United States, according to the Federal Trade Commission.
A Petersburg pharmacist told lawmakers Wednesday that pharmacy benefit managers are severely harming community pharmacies. David Baggett said over 300 independent pharmacies closed last year due to constant struggles with the industry middle men.
"I know of at least 25 stores that have closed this year all due to decreasing reimbursements from PBMs, meanwhile United Health group, CVS health and CIGNA report increased profits and earnings," Baggett said.
It has become an even bigger issue for people who need specialty drugs. The median annual brand price for MS therapies was $88,000 four years ago. The National MS Society said these critical drugs now cost $107,000 due to pharmacy benefit managers.
"People throughout the state living with MS are not seeing the price of their medications go down," said Corbin McGhee, advocacy director for the National MS Society. "It's the exact opposite. They're seeing it go up, and not just that. They're having to jump through hoops like step therapy, prior authorization and more just to get access to the medication that their doctor prescribes them."
Yet, pharmacy benefit managers said they shouldn't be blamed. Victor Perini with Accredo health group told lawmakers that drug manufacturers set the prices.
"The PBM's role is to negotiate in the drug supply chain between the manufacturers, the retail pharmacies and the payer of the pharmacy benefit so that we can reduce the net price," Perini said.
Citizen Action Illinois noted there is a lot of finger pointing about who is at fault, but director Anusha Thotakura argued everyone in the drug industry is playing a role in the unreasonable costs.
"We are seeing that medication, just due to being high cost, that could be dispensed at your pharmacy of choice or your provider's pharmacy of choice is not being able to be dispensed there because of these specialty contract provisions and designating more and more medication that should be deemed a specialty medication," Thotakura said.
Lawmakers plan to continue discussions about pharmacy benefit managers and a potential prescription drug affordability board in the coming months.Â
"They're amassing significant wealth while compromising the quality of healthcare and driving community pharmacies out of business," Baggett said. "I urge you to address the issue and ensure patients in Illinois receive the care they deserve."Â
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