Impact of pharmacy benefit managers on oncology practices and patients

Trevor J. Royce, Caroline Schenkel*, Kelsey Kirkwood, Laura Levit, Kathryn Levit, Sheetal Kircher

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Pharmacy benefit managers (PBMs) are thoroughly integrated into the drug supply chain as administrators of prescription drug benefits for private insurers, self-insuring business, and government health plans. As the role of PBMs has expanded, their opaque business practices and impact on drug prices have come under increasing scrutiny. PBMs are particularly influential in oncology care because prescription drugs play a major role in the treatment of most cancers and an increasing number of patients with cancer are treated with oral oncology agents managed by PBMs. There is concern that some PBM practices may threaten access to high-quality cancer care and may increase the financial and administrative burden on patients and practices. In this article, we review the role of PBMs in prescription drug coverage and reimbursement, discuss the impact of PBMs on oncology care, and present data from the 2018 ASCO Practice Survey assessing the knowledge and attitude of oncology practices toward PBMs.

Original languageEnglish (US)
Pages (from-to)276-284
Number of pages9
JournalJCO Oncology Practice
Volume16
Issue number5
DOIs
StatePublished - May 1 2020

ASJC Scopus subject areas

  • Health Policy
  • Oncology
  • Oncology(nursing)

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