Matzie highlights unfair reimbursement practices by pharmacy benefit managers

Applauds state auditor general for investigating practices that hurt consumers, taxpayers, local pharmacies

HARRISBURG, June 13 – At a Capitol news conference today, state Rep. Rob Matzie, D-Beaver/Allegheny, called attention to an unfair practice that has injured the state’s taxpayers and consumers and damaged the ability of local pharmacies to purchase prescription medications.

Matzie, co-chairman of the state Community Pharmacy Caucus, also applauded the state auditor general for agreeing to investigate the pharmacy benefit managers involved in the practice.

“To put it simply, they are operating in bad faith and need to be investigated,” Matzie said. They are overcharging patients and taxpayers untold millions and trying to drive local pharmacies out of business in order to fatten their own bottom lines.”

Pharmacy benefit managers negotiate with drug companies and insurers to help define which drugs are covered by health insurance plans. They also set drug reimbursement rates for community and chain pharmacies. There are examples of PBMs slashing reimbursement rates for local pharmacies to the point where they could not compete with the larger chains.

“This issue is about fairness,” Matzie said. “It’s about an even playing field. It’s about patients and taxpayers being ripped off and mom and pop stores being forced out of business. Your local pharmacist can’t tell you how to save money on the medicine you need. Not because they don’t want to – but because they are forced not to – by their PBM.

“We have entrusted these companies with an enormous responsibility – one to which it appears, at best, that they’re not meeting and at worst, that they’re abusing. This must be stopped. It’s time to look into this situation and time for legislative oversight. I applaud the auditor general for his efforts and offer any assistance moving forward.”