Mississippi has introduced legislation that would move the oversight of PBMs from the State Insurance Commissioner to the State Board of Pharmacy. From a clinical care perspective, there seems to be some logic here, but from a business perspective, it doesn’t work. Right now, the State Boards are generally made up of local pharmacists with an occassional PBM pharmacist on the board.
Since that group negotiates with the PBMs for rates, it would seem to create a major conflict of interest. PCMA has honed in on this and is actively fighting it.
I guess that’s like saying that hospitals should govern managed care organizations.
No, it is like saying doctors and nurses should have input to how your care is managed. Now we are saying pharmacist should have in put to how your prescriptions are managed. Or would you prefer your insurance agent perform your next surgery and your broker dispense your next prescription. It is health outcomes AND ROI not just ROI.