Pennsylvania auditor general calls for greater oversight of PBMs

Pennsylvania Auditor General Eugene DePasquale on Tuesday called on legislators to demand more transparency and accountability from PBMs. In an 18-page report, DePasquale said Pennsylvania paid PBMs $2.86 billion in 2017 for Medicaid beneficiaries’ prescriptions. By comparison, the report said the state paid PBMs $1.41 billion in 2013.

Pennsylvania Auditor General Eugene DePasquale on Tuesday called on legislators to demand more transparency and accountability from PBMs. In an 18-page report, DePasquale said Pennsylvania paid PBMs $2.86 billion in 2017 for Medicaid beneficiaries’ prescriptions. By comparison, the report said the state paid PBMs $1.41 billion in 2013. The report frequently cites independent pharmacists' testimony from five public hearings organized by the auditor general’s office last fall. J.C. Scott, president and CEO of the Pharmaceutical Care Management Association, called DePasquale's findings "highly biased," arguing the report "omits any mention of how PBMs are reducing prescription drugs costs and increasing access to needed medications for Pennsylvania's Medicaid beneficiaries." Meanwhile, Patricia Epple, CEO of the Pennsylvania Pharmacists Association, said the group was pleased with the report's findings and recommendations, calling PBMs "an unregulated middleman making huge amounts of money and profit off taxpayers, insurers, and patients." DePasquale's report set out 10 recommendations for legislators such as requiring greater transparency and oversight of PBM pricing and contracts—or taking over drug benefit management itself — and allowing annual reviews of PBM sub-contracts.