Although your June 12 editorial, “A new look at the middlemen inflating Mass. drug costs,” correctly points out that pharmacy benefit managers’ profit margins must be part of a broader health care strategy to bring drug costs under control, it incorrectly suggests that MassHealth’s move toward more managed care plans may lead to an increase in pharmacy benefit managers’ “spread pricing.” In fact, MassHealth recently has required its managed care providers to disclose their “spread price” details and has revised their contracts to enforce strict limits and transparency. Unlike other states, MassHealth does not use PBMs for the majority of our pharmacy program.
MassHealth prescription drug spending has nearly doubled, to $1.9 billion, over the past five years even as the caseload declines. In order to address the rapidly rising costs of drugs, we’ve asked the Legislature to allow MassHealth to negotiate directly with manufacturers. Our proposal subjects drug manufacturers to the same requirements that are applied to health care providers and insurance companies. MassHealth should be able to set fair rates for drugs on behalf of the taxpayers of the Commonwealth.
Executive Office of Health and Human Services