Pharmacy benefit managers are third-party entities that negotiate drug prices with manufacturers and pharmacies, establish drug formularies and process drug claims.
PHOENIX — Passing through the doorway of Melrose Pharmacy in uptown Phoenix feels like entering the 1950s. Its throwback decor harkens to another era.
But the pharmacy’s owner said she faces a distinctly modern challenge: pharmacy benefit managers.
“I have been frustrated with PBM’s since the day I opened,” said pharmacist Teresa Dickinson. “Every year I say it can’t get worse. And every year it gets worse.”
“They are the mafia of health care”
Pharmacy Benefit Managers are third-party entities that negotiate drug prices with manufacturers and pharmacies, establish drug formularies and process drug claims.
They have increasingly tighter relationships with insurance companies and according to the nonprofit Brookings Institute, just three PBM firms serve 79% of the market. Those PBMs are also owned or co-owned by insurance companies, posing a potential conflict of interest.
Dickinson alleged that PBMs have too much unchecked power to dictate the price of prescriptions, wh …
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