New Article Analyzes Impact of PBMs on Quality Cancer Care

April 20, 2020

JCO Oncology Practice published an article and accompanying infographic that examine the impact pharmacy benefit managers (PBMs) have on cancer care delivery. The article is part of the American Society of Clinical Oncology’s (ASCO) State of Cancer Care in America™ series, which explores challenges and opportunities in today’s oncology delivery system.

PBMs develop and manage prescription drug benefits for insurers and act as an intermediary in the prescription drug supply chain. As the role of PBMs has expanded, their opaque business practices and impact on drug prices have come under increasing scrutiny, making it difficult to know if the cost saving measures they promise translate to a reduced costs for patients. New ASCO data presented in the article show PBMs may reduce access and quality of care while increasing burdens on providers. The data was collected as part of the 2018 ASCO Practice Survey of 270 oncology practices representing more than 8,400 oncologists who care for adult patients in the United States.

Of the practices surveyed: 

  • 75% reported that PBMs interfered with patient care and/or made it difficult to deliver care
  • 34% say PBM policies caused treatment delays and increased patient stress
  • 56% reported that PBMs disrupted practice workflow causing administrative burden

Other issues raised by practices include PBMs shipping patients pre-mixed medications without appropriate safeguards, patients receiving incorrect dosages, and patients receiving incorrect medications. 

Read the full JCO OP article  to see other barriers to quality care caused by using PBMs and view the infographic for an overview of key findings. 

Read additional articles, graphics, and commentaries on the State of Cancer Care in America.