Bor Bor

After we helped the state of Ohio uncover $245 million in hidden PBM spread mark-ups in the Medicaid program back in 2018, an employer in Dayton asked if we could give them a hand in controlling their ballooning prescription drug costs. Their PBM denied them access to their claims data when they found out they were working with us. We have since worked with state Medicaid programs, state auditors, mid-size employers, state AGs, and even a couple Fortune 100 companies to help bring sobriety to their pharmacy spend, and even they still get hassles and incomplete information from PBMs. Last week, the @USDOL released a final rule package that sends a resounding message to the PBMs who have been working overtime to continue to hide the ball: "The jig is up." With years of lackluster results from the federal government to create a more transparent and efficient pharmacy benefits marketplace, I'd be lying if I said I put a lot of stock in the development of these DOL rules. And when the first impressive draft was released in January, I thought there was no way they would see them through with substance. They did. The rules are detailed, aggressive, and smart. They understand how complexity, opacity, and vertical integration have left employers and patients caught in a loser's game as they struggle to afford the growing tab for medicines. The rules aren't a silver bullet to cure all drug pricing ills. But they aren't just a flashlight in a dark cave either. They are a floodlight, a map, and a blow torch all rolled into one. Use these tools as DOL contemplates, and a new, better reality is more possible than ever before. This is not an administration I have been quick to compliment for their drug policy efforts. That isn't unique. I can't say many good things about any administration's approaches. But this one is the real deal. Big appreciation goes out to all the good people at DOL for taking their charge so seriously – and for understanding that the work has only just begun. It was unbelievably cool to see the standing-room-only DC event where the rules were unveiled, among a sea of individuals who have been working toward reform efforts for decades. It was a treat to hear the remarks from @DrOzCMS, @Sonderling47, @vincehaley, and Daniel Aronowitz about why the rules are critical for bending the cost curve on pharmaceuticals. It was a true professional honor to be able to speak on the event panel with @justindanhof, Steve Ditto, Julie Selesnick, and @PtRightsAdvoc price transparency warrior Cynthia Fisher about how the new rules can help employers smoke out scams, root out misaligned incentives, and shop for a better tomorrow. Event video: youtube.com/live/zWMU1-958IE… Final rules: federalregister.gov/document…