Garden State Times

The head of a New Jersey health care reform group said pharmacy benefit managers (PBMs) "have jeopardized patient care, cost taxpayers, and reduced patient choice" after a recent report from the Federal Trade Commission (FTC) was reviewed by New Jersey legislators. 

"The report found that anti-competitive policies of the largest PBMs have jeopardized patient care, cost taxpayers, and reduced patient choice," wrote Jeannette Hoffman, executive director of Patients Come First - New Jersey, in an ROI-NJ op-ed. "For example, the Committee found that PBMs have intentionally overcharged or withheld rebates and fees from many taxpayer-funded health programs."

U.S. Representatives from the House Committee on Oversight and Accountability recently heard testimony on the FTC report and on the three largest PBM's, which included details on how they were increasing the costs of medications, particularly cancer related drugs, and limit access to drugs in rural areas or medical desert regions. 

According to an FTC press release, the interim report, required by a special order issued by the FTC in 2022, outlines how increased vertical integration and concentration have contributed to the rise of six PBMs that now manage almost 95% of the nation’s prescriptions.

The FTC asserts that this vertical integration and concentration have led to PBMs profiting at the expense of patients and independent pharmacists. "The FTC’s interim report lays out how dominant pharmacy benefit managers can hike the cost of drugs—including overcharging patients for cancer drugs," FTC Chair Lina M. Khan stated in the press release. "The report also details how PBMs can squeeze independent pharmacies that many Americans—especially those in rural communities—depend on for essential care."

The interim report was published under Section 6(b) of the FTC Act and focuses on six large PBMs: Caremark Rx, LLC; Express Scripts, Inc.; OptumRx, Inc.; Humana Pharmacy Solutions, Inc.; Prime Therapeutics LLC; and MedImpact Healthcare Systems, Inc.

New Jersey Gov. Phil Murphy had previously signed into law bipartisan measures meant to increase oversight on PBMs, "however, after the indicting FTC report was released, a group of New Jersey lawmakers and independent pharmacists announced they would spearhead additional legislation to address the impact of PBMs and the crisis of rising drug costs in New Jersey," Hoffman wrote. 

"It’s clear, the only 'benefits' provided by PBMs are in the form of their own profits," said Hoffman. "Patients Come First New Jersey applauds our lawmakers at the state and federal level for exposing the disreputable practices of PBMs to ensure transparency, accountability, and affordability for all Garden State patients."

Commerce and Industry Association of New Jersey. She also previously worked as an aide to former Gov. Christine Todd Whitman (R-N.J.).

Patients Come First has also launched groups in California and Missouri.