PBM Reform: A Tipping Point for Healthcare and Big Pharma
Storyful Intelligence
Empowering business leaders to understand the new information environment.
What's Happening: Pharmacy Benefit Managers (PBMs) are at the center of the?U.S.?healthcare reform debate. In September, the?American Medical Association reported?70% of the U.S. market is controlled by four companies:?CVS Health's Caremark (21.3% market share), UnitedHealth Group's Optum Rx (20.8%), Cigna's Express Scripts (17.1%), and Prime Therapeutics (10.3%).
PBMs were created to coordinate drug logistics between manufacturers and pharmacies, taking a?modest cut (~10%) of the savings. But as drug therapies and treatments improved, those cuts yielded significantly greater profit margins, incentivizing?monopolistic practices?that?resulted in?$50 billion of lost revenue in 2023, according to the Federal Trade Commission (FTC).
PBMs (Pharmacy Benefit Managers) manage prescription drug benefits. They negotiate drug prices, decide which medications are covered, process claims, and set up pharmacy networks.
Why It Matters: Reforming the PBM landscape is not just about market efficiency—it's about restoring fairness and trust in healthcare. Pharmaceutical companies must embrace this challenge, and social listening can help them address patient concerns early and expeditiously.
Storyful Intelligence analyzed 11.3 million mentions of "PBMs" across social media, from June 26, 2024, to November 26, 2024.?Read on for insights into the evolving discourse around PBM reform.?
What Social Media is Saying
Public Demand for PBM Reform Dominates Social Media Conversations
Above: Analysis of 5k highly engaged posts about PBMs across X, Reddit, Facebook, and Instagram (June 26, 2024 – November 26, 2024).
An analysis of 5k highly-engaged posts across X, Reddit, Facebook, and Instagram reveals mounting public scrutiny over PBMs. These posts highlight the growing demand for transparency, reform, and patient-centered healthcare solutions.
Key Findings:
The Storyful Take: Pharmaceutical companies should align messaging with public demands for reform, positioning themselves as patient allies. Social media monitoring enables proactive communication strategies that resonate with shifting sentiment.
FTC, Congress, and States Demand PBM Accountability
Tracking the PBM Litigation News: Engagement Over Time
Above: Engagement over time chart based on 11.3m posts mentioning “PBMs” across X, Reddit, Facebook, and Instagram (June 26, 2024 – November 26, 2024).
Key Developments:
Standout Metrics:
The Storyful Take:?The convergence of public outcry, regulatory investigations, and bipartisan reform efforts signals a transformational moment for the healthcare industry. By embracing transparency and reform narratives, pharmaceutical companies can lead in reshaping the industry.
Patients Turn to Online Forums for Healthcare Guidance
Key Subreddits Saw Rapid Engagement Increases in 2024
Above: Stacked area chart of mention volume over time for the highest-engaged subreddits (June 26, 2024 – November 26, 2024.)
Storyful’s analysis of discussions across Reddit underscores the growing grassroots concern about Pharmacy Benefit Managers (PBMs) and their impact on pharmacies and healthcare access.
Key Findings:
The Storyful Take: Reddit and other grassroots forums are increasingly central to healthcare discourse. Pharmaceutical companies can harness these platforms to engage directly with stakeholders, highlight patient-centered success stories, and build trust with a reform-minded audience.
What’s Next: A New Model for Healthcare Leadership
By proactively addressing consumer demands and legislative changes, pharmaceutical companies can redefine their role in a system urgently in need of repair:
1. Elevate Transparency: Commit to clear, accessible pricing structures that restore faith in the system.
2. Advocate for Reform: Partner with bipartisan coalitions to ensure reforms reflect the needs of patients and communities.
3. Listen and Respond: Monitor platforms like Reddit and X to analyze sentiment and identify opportunities for engagement.?
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By Storyful Intelligence Senior Associate Sarah Grant
Taking Control: Creating Your Own PBM Reform with IPPN Pharmacy Benefit Manager (PBM) reform has long been a contentious topic within the healthcare industry. While significant changes have been discussed in legislatures, real reform remains elusive. PBMs continue to wield considerable power, often to the detriment of independent pharmacies. What if you could implement your own form of PBM reform? The Challenge of Waiting for Reform Despite widespread acknowledgment of PBMs' outsized influence, legislative progress has been slow. Proposed reforms often face fierce lobbying opposition and get watered down or stalled entirely. Even if reform passes, the impact may take years to materialize—if it happens at all. Be the Change While PBM reform remains uncertain, you have the power to enact meaningful change in your pharmacy today. IPPN provides the tools and support to create your own version of reform, one that prioritizes transparency, collaboration, and patient care over profits for middlemen. Take control. Embrace innovation. Create your own PBM reform with IPPN. Take the Next Step and go to https://ippnhub.com