To the Editor,
I have been reading the recent news concerning lost jobs and the county’s decision to cut the home health division. As the county looks for ways to cut costs a look at the county benefits consultant and the PBM (pharmacy benefits manager) would be a good place to start.
If there are undisclosed financial conflicts of interest between these entities and the county, the potential conflicts can lead to wasted taxpayer dollars. PBM’s are the claims processing middlemen between employers and pharmacies. The PBM industry originated as a means to reduce costs and administrative burden, but has morphed into a shady, unregulated industry that refuses to act as a fudicidary for the plan sponsors they serve.
Spread pricing, rebate retention, and mandatory mail order are just a few of the drug cost inflating games played by the PBM’s. Benefit consultants are the middlemen to the PBM middlemen and they make large sums of money by recommending to employers which PBM’s to use. what is often undisclosed by the benefits consultant, however, is how much money the PBM is paying to the benefits consultant (directly or indirectly from the insurance plan) to suggest certain PBM’s or specific programs (like mandatory mail order).
The County and State should be looking for totally transparent PBM’s for which to do business. The recent decision to switch from Medco (current Pbm for state employees), which I applaud, to Prime Theapeutics to me was a wasted opportunity to save the taxpayers of Surry County and the state of NC hard earned taxpayer dollars.