Arkansas is one of few states leading the nation to protect pharmacies by making sure they are fairly reimbursed for drug costs. The Arkansas Insurance Department just awarded the first licenses to Pharmacy Benefits Managers (PBMs).
These licenses will hold PBMs more accountable for how they handle their business because if they want to operate in Arkansas, they'll now have to play by the state's rules.
When your pharmacist fills your prescription, it's the PBMs job to reimburse them for the cost of the drug through your insurance company. Many pharmacists were losing money on sales because reimbursement prices were less than what they paid for the drug.
"When I have PMBs that are not paying for the full cost of the medication, I have to turn patients away," said Anne Pace, Pharm.D., Kavanaugh Pharmacy.
Now pharmacists can file complaints against them.
“There certainly are still PBMs who are not playing by the rules," Pace said. “So now we have someone to file complaints to.”
In March 2018, The Arkansas Pharmacy Benefits Manager Licensure Act passed requiring PBMs to earn a license to operate in Arkansas.
“It’s nice to have a referee on the playing field to help protect consumers, patients, and tax payers," said John Vinson, Pharm.D., Chief Operating Officer, Arkansas Pharmacist Association.
"Aetna" and "CVS Caremark" became the first companies to finish their applications. OptumRX has a 60 day temporary license as they complete their application.
This state oversight could keep your drug prices from rising because now, the Arkansas Insurance Commission can make sure PBMs are reimbursing all pharmacies fairly to make sure pharmacies, even in rural areas, stay in business.
"Usually when you have fair competition and a well-functioning market place, you'll get lower prices," Vinson said.