But if you take prescription meds, they’re the ones who usually control which ones you have access to.
“There are circumstances where a physician prescribes a medication for a patient and it’s not on the formulary. So there is a process which tends to delay for that patient to get therapy, and again it’s not on the formulary. The PBM’s determine what’s in and what’s not,” he said.Colleen Meiman, a national policy adviser for state associations of Community Health Centers, said in recent years, the benefit managers have changed their approach.
The Democrats want the IRA, while the Republicans push back. However, the Republicans complained the IRA doesn’t address PMBs. Theythe PBMs “and the rebates and fees they collect from drug manufacturers and pharmacies” the main “cause of high drug costs”:
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