Washington, D.C.—A new survey left no doubt how pharmacists feel about PBMs and how they negatively affect their ability to provide patients care.

In announcing the survey results, the American Pharmacists Association (APhA) noted, “PBM reform efforts have long been keystone issues for APhA’s members. In support of renewed interest in addressing these issues from lawmakers in Congress, federal regulatory agencies, and states, APhA’s survey sought to collect and quantify current pharmacists’ experiences with PBMs to inform policymakers and the public about their impact on pharmacies, pharmacists, and patients.”

The survey, which involved 547 respondents, was conducted by APhA from January 28, 2023, to February 15, 2023. The participants were recruited through email and social media platforms, including Facebook, Twitter, and LinkedIn.

The results of the survey were that:

• 91.5% of respondents agreed that PBM practices are negatively affecting their practice and their ability to provide patient care
• 93.3% of respondents agreed that patient steerage practices—incentivizing patients to use specific pharmacies, often owned by the PBM—impact their pharmacy and the patient care they provide. (Patient steering is requiring or incentivizing patients to use certain pharmacies, often ones owned by the PBM)
• 88.5% of respondents agreed that “clawback” fees, which are collected by the PBM after the point of sale, impact their pharmacy and the patient care they provide by increasing patient out-of-pocket costs for medications
• 82% of the respondents agreed that spread pricing, by which the PBM charges the plan sponsor more than they pay the pharmacy for a medication and keeps the “spread” as a profit, impacts their pharmacy and the patient care they provide
• 75% of pharmacists disagreed that the current ingredient costs/dispensing fees they receive from PBMs are sufficient to sustain their pharmacy business.

“This latest APhA survey data adds to the increasing evidence that PBM practices and tactics are resulting in inflated out-of-pocket drug costs for patients and continued struggles for America’s pharmacies to keep their doors open to provide patient care. PBM reform is needed now. APhA will continue working with policymakers and other relevant parties to restore transparency, accountability, and equity to the health care marketplace,” said APhA interim executive VP and CEO, Ilisa BG Bernstein, PharmD, JD, FAPhA.

The results of the survey were presented at a bipartisan congressional briefing which was sponsored by Reps. Larry Bucshon, MD, (R-IN); Buddy Carter (R-GA); and Diana DeGette (D-CO) on February 28, 2023.

The APhA also released a statement applauding House Oversight and Accountability Committee Chair James Comer (R-KY) for launching an investigation into PBMs’ role in rising healthcare costs.

“As explained during APhA’s PBM 101 briefing for congressional staff this week, there is already mountains of data from Medicaid and commercial plans on PBMs’ uncompetitive and deceptive trade practices that target patients with chronic conditions, that force them to use PBM-owned specialty and mail order pharmacies rather than their local pharmacy, for Congress to take action,” Dr. Bernstein said. “We look forward to working with the committee to restore transparency, accountability, and equity to our nation’s healthcare marketplace.”

The committee’s investigation calls for documents, communications, and information related to PBM practices.

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