The state of Delaware overpaid pharmacy benefit manager Express Scripts $24.5 million for state employees' prescription drugs between 2018 and 2020, according to a report released by state auditor Kathy McGuiness.
In the report, Ms. McGuiness said that "because of questionable and opaque practices and contract terms with its PBM, Delawareans spent more money than was necessary — most of it to line the PBM's pockets."
Ms. McGuiness examined Express Scripts, the state's PBM, between fiscal years 2018 and 2020, WDEL, a local news radio station in Wilmington, Del., reported June 18.
"My team reviewed the state's contract with [Express Scripts] and compared pharmacy reimbursement data. What we found was that Delaware's drug inflation rate for 2018-20 was nearly three times the national inflationary rate. That equates to a 20.1 percent increase in total plan costs from 2018 to 2020 alone, despite enrollment numbers remaining relatively flat," Ms. McGuiness told WDEL.
The state auditor said Express Scripts and other PBMs generate revenue through tax dollars by using such practices as "claw-backs, gag clauses, rebate-pumping and spread pricing — all of which significantly contribute to the skyrocketing of prescription drug prices."
She added that "predatory" PBM practices disproportionately affect small pharmacies.
"I have significant concerns about the impact these PBM middlemen have on our community," Ms. McGuiness told WDEL.
An Express Scripts spokesperson said in a statement to Becker's: "Express Scripts is committed to delivering high quality, affordable pharmacy services to our clients and members. We are reviewing this report, and we are confident that we performed in accordance with our contract with the State of Delaware."
CVS Caremark is set to become Delaware's PBM for state employees July 1.