(Reuters) – U.S. pharmacy benefit managers push patients towards more expensive treatments even when lower-cost options are available, according to a report by the House Committee on Oversight and Accountability.
The committee said it has found evidence that pharmacy benefit managers (PBMs) force drugmakers to pay rebates for placing their branded drugs in a favorable position on a formulary or the list of medications covered by various insurance plans.
A U.S. House of Representatives oversight panel hearing, which will include executives from top three U.S. PBMs – UnitedHealth’s OptumRx, Cigna’s ExpressScripts and CVS Health’s Caremark, is underway.
PBMs are companies that handle prescription drug benefits for health insurance companies, large employers, and Medicare prescription drug plans.
The three largest PBMs have used their position “to enact anti-competitive policies” and protect their own profits, the committee added.
It also said that PBMs share patient data across their several integrated units to steer them towards pharmacies that are owned by them.
PBMs have also begun moving some operations abroad to avoid transparency and proposed reforms, the report said.
(Reporting by Bhanvi Satija in Bengaluru; Editing by Shinjini Ganguli)
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