Dive Brief:
- Insurance lobby AHIP is launching a new seven-figure ad spot in outlets across Washington, D.C., that blames pharmaceutical manufacturers for rising drug costs.
- “Health insurance providers are your bargaining power, securing savings and providing more choices than ever before, helping you access quality care you can afford,” the 30-second spot says. “But while health insurance providers are working to make healthcare more affordable, Big Pharma is spending millions of dollars on drug pricing distractions designed to weaken your bargaining power and keep prescription drug prices high.”
- The ad spot comes as Congress heightens scrutiny of pharmacy benefit managers, drug purchasing middlemen that are often owned by health insurance companies. AHIP declined to provide the exact cost of the advertising push.
Dive Insight:
Drugmakers and health insurers have long pointed fingers at one another over the rising cost of medicine. Much of the squabbling revolves around the role of pharmacy benefit managers in the marketplace. Insurers tout PBMs, which create drug formularies and negotiate rebates and fees with drugmakers, as being a key agent in lowering spending, while drug companies say any savings garnered by PBMs are kept as profit and don’t get passed down to consumers.
Critics have been ringing the alarm over the middlemen’s role in rising health spending, complicated and often opaque contracts, controversial business practices and vertical consolidation that’s resulted in the largest PBMs being integrated with the biggest health insurance companies.
The three biggest PBMs — CVS Caremark, Express Scripts and OptumRx — control nearly 80% of the prescription drug market, and are owned by CVS (which owns payer Aetna), Cigna and UnitedHealth (which operates payer UnitedHealthcare), respectively.
AHIP’s marketing push comes as lawmakers and regulators at the state and federal level take a harder look at PBMs. Earlier this year, the House Oversight and Accountability Committee launched an investigation into pharmacy benefit managers over alleged anti-competitive tactics, following a similar investigation started by the Federal Trade Commission last year.
A number of states also have targeted PBMs with lawsuits this year, including Ohio, which is suing three PBMs over alleged price fixing, and California, which is suing PBMs and drugmakers over insulin prices.
