APhA Policy Manual

Addressing Structural Conflicts of Interest, Patient Safety, and Market Distortions by Pharmacy Benefit Managers

PHARMACY PRACTICE

APhA supports structural, financial, and operational safeguards to address conflicts of interest between pharmacy benefit managers, insurers, and affiliated entities in the pharmaceutical supply chain.
APhA supports policies that prohibit pharmacy benefit managers, insurers, and affiliated entities in the pharmaceutical supply chain from using ownership relationships to engage in patient steering, self-preferencing, discriminatory reimbursement, anticompetitive network design, or other practices that restrict patient choice, undermine pharmacy access, increase patient and total cost of care, or restrict access to clinically appropriate medications.
APhA supports enforceable structural remedies when vertically integrated ownership arrangements create conflicts of interest that harm patients, pharmacies, competition, or the delivery of clinically appropriate care.
APhA supports state and federal oversight, transparency, and enforcement authority to prevent anticompetitive and discriminatory business practices by vertically integrated pharmacy benefit managers, insurers, and affiliated entities.
APhA supports preserving integrated care models that demonstrably improve patient care, access, affordability, and care coordination, provided they do not restrict patient choice, disadvantage competing pharmacies, or create unfair market conditions.