Press Release

RELEASE: Transparent PBM to Present Innovative Business Model at House Hearing on Rx Drug Prices

Alternative PBM passes 100 percent savings to consumers, keeps costs in check, and does not benefit from increased list prices

Washington (May 8, 2019) – The Alliance of Community Health Plans (ACHP) renews its call for an innovative, alternative solution to controlling prescription drug costs for consumers as transparent PBM model Navitus testifies before the House Energy & Commerce Health Subcommittee on May 9.  The transparent PBM model, already used by ACHP member plans like Dean Health Plan’s Navitus, is a proven, fully-transparent method that puts patients first and lowers the overall cost of care.

“Some ACHP member plans have fully transparent, fee-based PBM models that pass 100 percent of the rebates they secure back to clients. There are no hidden fees or black boxes and they keep drug costs in check for consumers,” said ACHP President and CEO Ceci Connolly. “This unique PBM model increases transparency in the drug supply chain and drives down costs in the system. We commend the House Energy & Commerce Committee for spotlighting this innovative, alternative PBM model.”

Not all PBMs are the same. The transparent models eliminate the perverse incentives of traditional PBM models in which drugs with higher list prices receive preferred treatment. Transparent PBMs also have a proven track record of reducing costs

Brent Eberle, Chief Pharmacy Officer of Navitus, will provide testimony at tomorrow’s hearing. In his remarks, Eberle submits, “[w]e believe that transparency in the market is the most important first step that can be made to truly understand the cost of drugs. Transparency is what our clients want and transparency is what we provide. We firmly believe that transparency should be the norm, not the exception.” 

ACHP, whose members are affiliated with Navitus as well as two other transparent PBMs – Independent Health and SelectHealth – has urged the Administration not to upend the entire rebate system at the expense of transparent PBM models that keep drug costs in check, most recently in their response to the HHS proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals.

To access the full text of ACHP’s recommendations to HHS, click here.

To access Navitus’s full testimony, click here.

About ACHP The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. ACHP’s member health plans provide coverage and care for more than 21 million Americans across 34 states and the District of Columbia. These organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and quality of care, including primary care redesign, payment reform, accountable health care delivery and use of information technology. To learn more, go to www.achp.org and follow ACHP on Twitter @_ACHP.