Transparency-Rx, a new not-for-profit coalition led by transparent pharmacy benefit managers (PBMs), launched a six-figure digital media campaign today highlighting the demand for meaningful PBM reforms that reduce prescription costs and bolster value for employers and patients. The advertisements will appear on a diverse range of news sites, cable, and streaming platforms across the Beltway and in targeted markets across the country, reaching policymakers, stakeholders, and a projected initial audience of more than 16 million.
The ad campaign underscores how transparent PBMs reduce out-of-pocket costs for patients and provide greater clarity across the health care system. Local businesses that use transparent PBMs save an average of $20 per prescription when compared to other PBMs. A separate advertisement reveals that major PBMs grossed more than $400 billion by linking their profits to drug prices in 2020.
“This media blitz shows transparency saves local business and taxpayers significantly, especially as big PBMs continue harmful drug pricing schemes that raise costs. Transparent PBMs are the clearest alternative,” said Transparency-Rx Managing Director Joseph M. Shields. “Medicare and the commercial market desperately need the important PBM reforms Republicans and Democrats are championing in Congress to help patients and local businesses drastically reduce medical costs.”
Under traditional or “big three” PBM models, profits and fees are tied to the prices of medicine, often steering seniors and patients away from generic or lower-cost competitive drugs. A recent report from Nephron Research finds that PBM compensation from fees tied to drug prices doubled between 2018-2022. Under “de-linking”, under bipartisan consideration in both chambers of Congress and embraced by the Biden Administration, PBMs would instead rely on administrative charges untethered from the price of medicines and offer flat fees for patients and plans. This reduces costs of critical medicines and helps patients stay on prescribed life-changing drugs. A “de-linked” model, based on disclosed fees, is the norm and regular business practice of transparent PBMs.
Analysis by the Congressional Budget Office (CBO) and other experts find that de-linking and related PBM reform policies could save more than $4 billion for U.S. taxpayers and the nation’s economy. Moreover, polls indicate voters of all parties and demographics overwhelmingly support and demand strong and meaningful PBM reforms.
“With Congress back and a funding deadline looming, the savings generated by popular PBM reforms provide a clear opportunity for leaders to kill two birds with one stone,” said Shields. “It’s a no-brainer: in one breath Congress can begin cleaning up big PBMs, reduce drug prices, and use savings to empower additional priorities.”
Transparency-Rx launched in September 2023 with a forward-looking policy platform that embraces many of the industry changes currently under consideration by Congress and increasingly advanced by state policymakers. These include a ban on spread pricing, instituting a 100% pass-through model for discounts, de-linking PBM fees from the price of drugs, reform of group purchasing organizations tied to big PBMs, and technology that backs data sharing with patients, insurers, pharmacists, and other stakeholders.
Transparency-Rx’s growing coalition represents more than 14.5 million lives across all 50 states. Founding members include AffirmedRx, Liviniti, MedOne Pharmacy Benefit Solutions Rx, Navitus Health Solutions, RxPreferred Benefits and SmithRx. Additional information about Transparency-Rx is available here.