Pharmacists cheer ‘historic victory’ against pharmacy benefit managers
Several pharmacy associations applauded a recent Supreme Court decision regarding how much pharmacy benefit managers reimburse pharmacies for the cost of drugs covered by employer-sponsored health plans.
Arkansas, Texas and 44 other states argued to the court that they — not the federal Employee Retirement Income Security Act of 1974, or ERISA — should regulate PBMs to avoid “harmful business practices in health care and protecting consumers’ access to medication,” a press release from the Texas Pharmacy Association said.
The Supreme Court unanimously ruled last month in favor of an Arkansas law that requires PBMs to reimburse pharmacies for drugs at a price that is “equal to or higher than” the wholesale cost, saying the state law is not preempted by the federal law.
“This is a historic victory for independent pharmacies and their patients,” B. Douglas Hoey, MBA, a pharmacist and CEO of the National Community Pharmacists Association, said in a press release.
The ruling increases drug pricing transparency and pharmacy access for patients and improves freedom of choice and health care for patients, the Arkansas Pharmacists Association said in a press release.
Conversely, the Pharmaceutical Care Management Association (PCMA) said in a statement that it was “disappointed” in the Supreme Court decision, claiming it undoes federal protections under ESIRA. The PCMA also said ERISA helps secure “access to affordable, quality prescription drug coverage” and that giving reimbursement power to the states will “create an unworkable patchwork of regulation around prescription drug benefits.”
“As states across the country consider this outcome, we would encourage they proceed with caution and avoid any regulations around prescription drug benefits,” PCMA said.
- National Community Pharmacists Association. Battleground: SCOTUS. https://ncpa.org/scotus. Accessed December 29, 2020.
- Pharmaceutical Care Management Association. PCMA statement on U.S. Supreme Court decision in Rutledge v. Pharmaceutical Care Management Association (PCMA). https://www.pcmanet.org/pcma-statement-on-u-s-supreme-court-decision-in-rutledge-v-pharmaceutical-care-management-association-pcma/. Accessed December 29, 2020.
- Pharmaceutical Care Management Association. PCMA defends access to affordable, high quality health plans for American job creators, employees and patients at Supreme Court. https://www.pcmanet.org/pcma-defends-access-to-affordable-high-quality-health-plans-for-american-job-creators-employees-and-patients-at-supreme-court/. Accessed January 1, 2021.
- Texas Pharmacy Association. Supreme Court rules in favor of pharmacists, patients: Decision validates Texas efforts to rein in PBMs. https://www.prweb.com/releases/supreme_court_rules_in_favor_of_pharmacists_patients_decision_validates_texas_efforts_to_rein_in_pbms/prweb17609552.htm. Accessed December 29, 2020.
- U.S. Supreme Court. Recent decisions. https://www.supremecourt.gov/. Accessed December 29, 2020.