Affordable for Whom? Debunking the Website Marylanders for Affordable Rx

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At first glance, Marylanders For Affordable Rx appears to be a coalition of concerned Maryland citizens. Nothing could further from the truth. Other So-called “patient coalitions” with the moniker “(State residents) for Affordable Rx” have popped up across the U.S. but are not actually patient groups at all. They are front groups created by the Pharmaceutical Care Management Association (PCMA), a trade association/lobbying organization representing the nation’s 11 largest pharmacy benefit managers (PBMs). 

These sites, including Maryland's “Affordable Rx” site, are rife with misinformation and appear to have been created to for the purpose of distorting facts and spreading misinformation, most likely in an attempt to discredit the independent pharmacies who’ve successfully demonstrated the depth and breadth of PBM anti-competitive practices and profiteering.

Here are the facts behind the misleading claims on the Marylanders for Affordable Rx site:

  • The number of independent pharmacies in Maryland has skyrocketed in the past ten years, up 36% – they’re doing better than larger chain pharmacies.

FACT: In 2016 Maryland independent pharmacies numbered 387. In 2019, that count rose by 7,  to 395. In contrast, PBM-owned retail and specialty pharmacies rose from 414 in 2016 to 436 in 2019

  • Profit margins for prescription drugs at independent pharmacies increased 2017-2018; pharmacists already make six-figures... they don’t need to price-gouge

This information is simply not true. The PBM determines the rate at which pharmacies are reimbursed for dispensing health plan-covered medications. Very often, those reimbursements are below the acquisition cost of the drug -- which is why local pharmacies have begun to publicly protest the PBM managed care model. In addition, the salary data cited in this statement comes from national salary aggregator sites and is not a reliable indicator. Realistically, independent pharmacists are small business owners who often eschew their salaries to keep their businesses afloat -- unlike the CEOs of national chain corporations who make 8-figure salaries that are 790 times more than their average employee. For information on the salaries and compensation of the officers of PBM corporations like CVS Caremark, Cigna/Express Scripts, and other PCMA members, we recommend checking their public filing records with the SEC.

  • The independent pharmacies of Maryland are important parts of local communities, but lately they’ve been more focused on profits than patients. Unknown to many, they use powerful corporations called pharmacy services administrative organizations (PSAOs) to bargain on their behalf for higher profits.

85% of the U.S. prescription drug market is controlled by the 3 largest PBMs, and they actively work to route all lives covered to their own pharmacy channels. In contrast, independent pharmacies must build their own patient base and do not have the bargaining power of bulk purchase (think Walmart vs Joe’s Local Grocery). PSAOs are pharmacy administrative organizations that help provide pharmacies some support, but are little more than administrative messengers and have no real bargaining power. 

  • Last year, Maryland exposed this behind-the-scenes game and passed the first-of-its-kind legislation to bring more transparency to these relationships.

Last year Maryland passed bi-partisan transparency legislation in an effort to shed light on the secretive PBM industry. Similar legislation has also been passed in the states that also, coincidentally, now have “Affordable Rx'' sites, including New York, Ohio, Kentucky, Georgia, and Arkansas.  

PCMA’s central argument rests on the grounds that states don’t have the right to govern their own taxpayer-funded healthcare. Yet, The U.S. Supreme Court unanimously decided states do, in fact, have that right, and is one indicator of the need for greater PBM transparency. Additionally, Numerous independent studies proving millions of dollars in overcharging and spread-pricing by PBMs at state and federal levels warrants a much deeper look into their business practices here in Maryland.

Marylanders want and deserve 'AffordableRx' -- a healthcare system that puts patients first and keeps local health care dollars just that - local.  Maryland’s community and independent pharmacies are working to expand and protect Maryland’s patients and consumers’ rights to understand how their drugs are priced.  

The real question is this, if PCMA must resort to creating front groups to distract patients and consumers from the facts, shouldn’t we ask why?