Rising drug costs are wreaking havoc on Mississippi’s insurance system. Lawmakers don’t know what to do. [Northeast Mississippi Daily Journal, Tupelo]

Rising drug costs are wreaking havoc on Mississippi’s insurance system.  Lawmakers don’t know what to do. [Northeast Mississippi Daily Journal, Tupelo]

Aug. 30-JACKSON – Lawmakers looked for ways to reduce the burden of taxpayers to the insurance policy that affects public employees, but the main discussion turned to investigating the behavior of drug dealers.

“Over the past 10 years, the cost of drugs to the public health insurance system for taxpayers has increased by 60%,” Home Insurance Committee Chairman Hank Zuber he said. “That is unsustainable. We cannot continue that way.”

The health insurance plan, which covers about 200,000 government employees and retirees, is managed by Department of Finance and Administrationbut benefits are controlled by Blue Cross & Blue Shield of Mississippi and CVS Caremark to provide prescriptions to enrollees.

Pharmacy benefit managers, often referred to as PBMs, are small contractors that are often hired by health plans or employers to manage drug benefits, negotiate drug prices with manufacturers and reimburse suppliers. medicine.

Part of the job of PBMs involves negotiating rebates and other discounts for drug manufacturers, and in exchange they offer a favorable environment to the drug manufacturers.

Over the past few years, as consumers have begun to pay more for prescription drugs and independent pharmacies say they are losing money selling drugs, the role of PBMs has come under scrutiny.

Proponents of PBMs say they save taxpayer dollars by adjusting annual premiums to provide insurance benefits. But PBM critics say the system — while well-intentioned — has been skewed to enrich the pockets of managed care organizations.

One thing is for sure – caregiving organizations make huge profits. CVS Health and UnitedHealth are among the wealthiest companies on the annual Fortune 500 list.

Michael PowerDirector of State Affairs of the Pharmaceutical Care Management Associationestimates that the various PBMs that governments contract with save Mississippi about $1 million every year.

“You think the portion that the government would receive would be a little bit bigger than the portion itself $1 millionright? ” Senate Medicaid Chairman Kevin Blackwell he said.

“I don’t have those numbers in front of me from the government, so I can’t,” Power replied.

“Well, I would,” replied Blackwell, R-Southhaven.

PBMs say drug manufacturers have the primary responsibility for setting drug prices, and there is nothing preventing them from selling their drugs to retailers at a lower price.

But Zach PossPhRMA’s public relations representative, told lawmakers that in order to play football in the larger game with a successful business, manufacturers must cooperate with PBMs to get a top spot on their approved drug list.

Because of the back-and-forth dance between manufacturers and PBMs, federal and state leaders are beginning to think that manufacturers are encouraged to keep prices high in order to provide discounts to PBMs.

The case also turned into a national debate surrounding the pharmaceutical industry and who is to blame for the high prices of drugs at pharmacies.

Sen. Josh HarkinsRepublican from Flowood who is a real estate agent, compared the pharmaceutical industry to real estate Mississippi.

The Rankin County the lawmaker said that if he deliberately induces buyers and sellers of other properties to try to get more money, then he can have his real estate license revoked for bad behavior.

“You negotiate on behalf of the plans with the developer,” Harkins said. “You also negotiate with the pharmacist. So you are on both sides. You are negotiating the price of buying the product and setting the price. You are also setting the price of what the pharmacies are distributing.”

The legislative hearing comes at a time when the State Auditor Pictures of White Shad The office has signed a contract with a data analysis company to collect information about the PBM – CVS Caremark – which helps to manage the health insurance policy.

Zuber, R-Ocean WellsHe said he wants to hold more discussions before the 2023 legislative session to try to find a long-term solution to reduce the cost of the state’s health insurance plan.

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