Magazine article Drug Topics

Rx/PBMs Won't Control Market, They Claim

Magazine article Drug Topics

Rx/PBMs Won't Control Market, They Claim

Article excerpt

Would the acquisition of pharmacy benefit managers by manufacturers lead to a monopoly of the market? Representatives from two such mergers were asked this question at a conference in New York City recently, and here's what they had to say.

According to Robert Hills, executive v.p. at Merck-Medco U.S. Managed Care, PBMs now manage the pharmacy benefit for fewer than 100 million people in this country, if you factor out all the double counting of covered lives that goes on. The rest of the population is in other programs, such as Medicaid or unmanaged indemnity plans not subject to PBMs. Even for patients managed by PBMs, there's intense competition between the players, "so there's certainly no monopoly there," Hills claimed.

PBMs are also not as mighty as some believe. Hills said he knows of no PBM of that can affect utilization in the hospital setting, especially when it comes to biotech products, which are frequently of hospital-initiated.

Singing the same song was Henry Blissenbach, president of Diversified Pharmaceutical Services, a Minneapolis PBM recently acquired by SmithKline Beecham.

Even if Diversified wanted to carry only SB products on its formulary, it couldn't, Blissenbach said, because no manufacturer now makes a full line of products. …

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