PBM-Insider Should Not Head HHS Rx Transparency Effort, AAPS Tells Sec. Azar.


The Association of American Physicians and Surgeons (AAPS) has asked the Department of Health and Human Services to reconsider its appointment of a vice president of the nation’s second largest Pharmacy Benefits Management firm, CVS Caremark, to head its initiative to improve prescription drug price transparency.

In a letter to HHS Secretary Alex Azar, AAPS writes:

While this individual no doubt is well-versed in the consequences caused by lack of transparency, our concern is that his conflicts of interest could prevent him from serving in a manner free from bias towards solutions that benefit his industry connection.

PBMs are under increasing scrutiny by the media, legislators, regulators, the courts, and others for their role in bloating costs for patients and improperly making decisions that drive the choice of pharmaceutical treatments patients receive. In fact, PBMs and their Group Purchasing Organization (GPO) cousins also reportedly share responsibility for the epidemic of drug and medical supply shortages that are currently harming patient care. Physicians Against Drug Shortages, a volunteer-led grassroots patient advocacy organization working to expose these practices, estimates that PBM “rebates” inflate prescription costs by $100 billion annually.

Non-transparent business arrangements and hidden pricing games empower these improper practices, and thus an executive at a PBM like CVS Caremark is, in our opinion, the wrong choice to lead efforts to increase prescription transparency.

Meanwhile, independent physicians are providing tremendous savings to patients with in-office dispensing of prescriptions that cut out the cost increases caused by middlemen like PBMs.  For example, a 72-year-old female patient with multiple chronic conditions purchases all nine of her medications through a Direct Primary Care office for $14.63/month. Through her Medicare “coverage” her cost would be $294.25 per month.

In addition to sharing these concerns AAPS expressed its gratitude for the increased attention HHS is shining on the need for price transparency in American medicine. “Abundant access to low-cost, high-quality care is not going to be achieved in the current environment where hiding cost and pricing information is the norm,” concludes the letter.

The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in virtually all specialties and every state. Founded in 1943, AAPS has the motto “omnia pro aegroto,” which means “all for the patient.”