In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they dissect the critical role of Pharmacy Benefit Managers (PBMs) in the health care system, guided by recent findings from the Federal Trade Commission (FTC). The episode delves into how PBMs control a significant portion of the U.S. prescription market, discussing the implications of their dominance on drug prices, and the viability of independent pharmacies. Featuring a thorough examination of the FTC's recent report, Dr. Popovian explores the deep-seated issues of market concentration, anti-competitive practices, and the need for substantial regulatory reform.
This episode aims to shed the light on the powerful influence PBMs have over drug access and affordability, proposing pathways for more equitable health care practices.
Among the highlights in this episode:
01:45: Dr. Popovian delves into the FTC's report, revealing that three major PBMs control 80% of the retail prescription market in the U.S., highlighting issues of market concentration and limited competition
02:46: The conversation shifts to the impact of PBMs on drug prices and pharmacy operations, focusing on the FTC's concerns over anti-competitive practices
03:14: Dr. Popovian explains the effects of vertical and horizontal integration among PBMs, affecting drug access and pricing
06:35: Our hosts discuss the struggles faced by independent pharmacies due to PBM practices, as revealed in the FTC report
09:59: Dr. Popovian explores how PBMs use formulary design to manipulate which drugs patients can access and at what cost
11:59: Dr. Popovian criticizes the current rebate practices by PBMs, discussing their detrimental effects on the availability of generic and biosimilar drugs
14:25: Dr. Popovian calls for greater transparency and potential regulatory reforms to ensure fair drug pricing and maintain pharmacy viability
16:44: Dr. Popovian shares some final thoughts
To read the full FTC report “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies,” go to: https://www.ftc.gov/reports/pharmacy-benefit-managers-report
Contact Our Hosts
Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org
Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org
A podcast series produced by Ben Blanc.
We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org
Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.
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