Ted Okon Discusses the Impact of PBM Involvement in 340B

The involvement of pharmacy benefit managers (PBMs) in 340B is the “colliding of 2 worlds,” said Ted Okon, MBA, executive director, Community Oncology Alliance (COA).

Transcript

The COA has raised concerns about pharmacy benefit manager contracting in the 340B program. Do you think the FTC probe will impact this for the benefit of patients?

You know, we've really seen the colliding of 2 worlds, and that is 340B program, which is out of control, and the PBMs literally taking over the contract pharmacy world of 340B. That's why you have over 16 manufacturers that are now in litigation, because they have stopped selling to multiple contract pharmacies.

How this plays out is that the PBMs want drugs to come through their mail order and specialty pharmacy. In the world of oncology, it's why we see PBMs literally mandating more that they dispense the drugs through the mail, as opposed to the patient getting it right there at the practice. That causes delays. It causes denials. It causes waste when there are wrong dosages, and this happens a lot of the time. I think we're going to see more white bagging as well too of injectable drugs, because I think that the PBMs, again, through their specialty pharmacies, which are 340B contract pharmacies, want to see more drug come through them.

So, this is going to be a real problem. I'm not so sure that the FTC is really aware of this problem. We are going to make them aware of it. It's one of the reasons why COA recently filed an amicus brief for the [Eli] Lilly lawsuit with HHS of not selling to multiple contract pharmacies. And we are working on an amicus brief for the AstraZeneca lawsuit as well, too.

Not that we wanted to do Lilly or AstraZeneca a favor, but we wanted to basically inform the courts that this program, which was intended to help patients in need, is now going to the coffers of some of the largest corporations in this country.