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The PBM Pushback
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Released: January 02, 2025

Expiration: January 01, 2026

John Marshall
John Marshall, MD
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MedBuzz: The PBM Pushback

[00:00:00]

John Marshall, MD: Ho, Ho, Ho, everybody out there. This is John Marshall for Oncology Unscripted, and we're going to talk a lot about pancreatic cancer today. We're also going to talk about some other things as well, but I thought I would sort of start off with a little holiday story.

See that stocking? I've had this stocking for a long, long time. I actually keep it right over there in my drawer, and it's a reminder of what we do for a living. So, a patient almost 30 years ago gave me this. It was actually a breast cancer patient I was covering for one of my colleagues who was out on maternity leave, and during that three-month window, I was the one who gave her the scan that showed the recurrence of her breast cancer. And so, I was the messenger if you will, of the bad news. And she pretended like nothing was really a big deal, and it was fine. My colleague came back and managed things from that point on. But then that Christmas season, that year, I got a very beautifully wrapped box. I thought, oh, how nice that this patient I was covering for those three months, many years ago had given me this gift and I opened it up and inside was this stocking. I thought, well, that's pretty nice. I don't really understand it. And then I felt and inside the stocking is a lump of coal. And this was a patient who had taken a lot of trouble to wrap me up a pretty gift with a stocking in it, mainly to make sure I knew that I was the Scrooge for her holiday season.

And so, as we enter this holiday season with our patients, with our colleagues and our teams around us, remember. It is a special time of year for all of us. It's an important time of year, but it's also a time of year when bad news carries a little bit harder weight with our patients. So, avoid getting one of these from your next patient if you get one of those bad scans, which sadly is common among our pancreas cancer patients.

But before we go there. talk a little bit about one of our past topics, a little bit of gossip that's out there, and that's the pharmacy benefit manager. If you remember, we talked about this a few episodes ago where this group CVS Caremark, and there are many of them now, nearly three big ones, are controlling the pricing of our medicines in such a way that they're ramping up pricing, controlling the distribution, and really kind of undermining a lot of the free enterprise, if you will, out there. And so I'm sure it wasn't our video and commentary that caused this, but there's been some backlash from the PBMs who now are like filing lawsuits against the Federal Trade Commission, claiming that basically they're fiddling with all of this is unconstitutional. And they've had full page ads running in the Washington Post. We always know when there's something going on here in Washington because they'll take out a full-page ad saying we're right. You're wrong. You should support us. I guess it’s sort of subliminal messaging for our Congress people as they go to work in the morning. Nonetheless, there's now this pushback from PBMs to say, stay out of my business. It's not the government's business.

And so now I'm thinking about what's coming in the year ahead. You don't want regulation. Okay, you voted for him. He's not going to have any regulation, at least as far as I can tell. But this is one of those examples of what's going to happen if we don't push back, it's going to affect all of us going to affect the cost of health care. And we won't be the ones who are benefiting from this. These third-party managers, such as the PBMs, will be the ones that are benefiting. So, it's going to be to see what happens in the year ahead. Just how much changes in regulation, particularly for us in health care, will have an impact on outcomes, cost, access, all those important things that we are trying to get for our patients. So, I don't know. Stay tuned. More stories to come on the PBMs.[00:04:18]

This transcript has been edited for clarity.