Decision in Rutledge v. PCMA Validates State Efforts to Rein in PBMs
Charleston, WV – The Supreme Court of the United States today issued its landmark decision in Rutledge v. Pharmaceutical Care Management Association (PCMA), ruling in favor of an Arkansas law to prevent abusive PBM payment practices.
The unanimous decision empowers states to take action to hold pharmacy benefit managers (PBMs) accountable for their role in managing drug benefits that profit at the expense of local pharmacists, pharmacies and the patients who depend on them.
“This ruling removes a significant barrier in providing patients with access to their pharmacy of choice and increased price transparency” said West Virginia Pharmacists Association President, Katie Kacmarik, PharmD. “This is a big win for our pharmacies, pharmacists, and patients. But, there’s much more work to do to strengthen PBM regulations to benefit patients in the future.”
The Arkansas law upheld by the Supreme court today prohibits PBMs from reimbursing local pharmacies at a lower rate than what the pharmacies pay to fill prescriptions. PBMs often profit by reimbursing pharmacies at less than a pharmacy’s cost to acquire a drug. This is just one of the many ways the PBM system puts pharmacies and patients at a disadvantage.
“Today is a historic day for the millions of men and women who play a critical role in ensuring public health. As we all navigate an ever-changing COVID-19 world, it’s critical that we let pharmacists and pharmacies do what they do best: serve patients and communities,” commented WV Pharmacists Association Vice President, Matthew Rafa, PharmD
“The West Virginia Legislature and the West Virginia Offices of the Insurance Commissioner have thankfully put regulations in place to limit PBM abuse of pharmacies and patients. We look forward to improving our law – especially the ‘Pharmacy Audit Integrity Act’ – following this unanimous SCOTUS decision.” stated Matt Walker, West Virginia Independent Pharmacy Association Executive Director.
Read more about this landmark decision and background from the National Alliance of State Pharmacy Associations