sculpture of a man and horse outside a federal building
The "Man Controlling Trade" statute outside the FTC's Washington, D.C., headquarters. HIV/AIDS clinics recently submitted comments to the commission about PBMs' business practices.


HIV/AIDS Clinics Tell FTC that PBMs Usurp 340B Discounts for Themselves

Pharmacy benefit managers (PBMs) should be stopped from usurping 340B drug discounts from HIV/AIDS clinics and other safety-net providers, Ryan White Clinics for 340B Access (RWC-340B) told the U.S. Federal Trade Commission (FTC) last week.

RWC-340B asked the commission for protection from PBMs in an April 22 letter. The FTC in late February invited the public to comment on how large, vertically integrated PBMs are affecting drug affordability and access. It did so days after an unexpected 2-2 tie vote doomed Chair Lina Khan’s proposal that the commission investigate PBMs commercial practices. The deadline for comments is May 25. Drug manufacturers and other stakeholders are expected to submit comments as well.

RWC-340B told the commission that PBMs have been trying almost since 340B’s creation 30 years ago to seize 340B discounts for themselves or put 340B pharmacies at a competitive disadvantage with respect to pharmacies affiliated with the PBM. It said PBMs:

  • offer reduced reimbursement for 340B drugs and to 340B pharmacies
  • prevent 340B pharmacies from fully participating in a PBM pharmacy network
  • favor their own retail contract pharmacies in their network over 340B pharmacies
  • retain portions of what they are paid by insurance plan sponsors instead of transferring the full payments to pharmacies
  • force pharmacies to adhere to burdensome prescription claims identification methods for submitting 340B eligible claims.

“All these discriminatory practices are antithetical to the purpose of the 340B program,” RWC-340B said.

After the FTC failed to approve an investigation of PBMs, their trade group Pharmaceutical Care Management Association said in a statement, “PBMs are holding drug companies accountable by relentlessly negotiating the lowest possible cost on behalf of patients and are driving and delivering local competition that patients are demanding.” 

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