By Mike Lillis - 09/09/10 04:24 PM EDT
An insurance giant has signed on as the newest member of Washington's leading pharmaceutical benefit manager (PBM) lobbyist group.
Wellpoint, Inc., the Indianapolis-based insurer, will join the Pharmaceutical Care Management Association (PCMA), the groups announced Thursday.
"WellPoint has a unique role in the insurance market as the nation’s largest healthcare benefits company that also continues to maintain control over our formulary and clinical programs," Pete Clagett, a WellPoint vice president, said in a statement. "We look forward to working with PCMA to communicate with the news media, policymakers, and others the integral role PBMs play in lowering costs and enhancing access for consumers and payers."
PBMs act as middlemen, negotiating prices and processing claims between pharmacists, insurers and drug makers. The industry has been under the microscope in recent years over allegations that some PBMs overcharged for drugs and that others sought kickbacks from drug makers to favor their products.
In response, the new health reform bill requires PBMs operating under Medicare or exchange plans to disclose details about its price negotiations to the Health and Human Services Department.
Mark Merritt, president and CEO of PCMA, welcomed the addition of Wellpoint on Thursday, saying the PBM model provides "workable prescription drug solutions for policymakers seeing to balance cost and access."
This post was updated at 5:30 p.m.