Indiana Pharmacy Association Underscores Urgent Need for PBM Reform Following Former Industry Leader’s Call for Change

• By: admin
• On: 12/08/2025 08:39:03
• In: IPA News

(Indianapolis, Indiana) November 24 2025— The Indiana Pharmacy Association applauds Mark Merritt's recent op-ed in the DC Journal, which delivers an urgent call for pharmacy benefit manager (PBM) reform, a bipartisan solution for rising premiums and prescription prices. Merritt, former President and CEO of the Pharmaceutical Care Management Association (PCMA), spent years representing PBMs. His insider perspective makes his call for reform especially significant, underscoring what pharmacists and patients have long known: the current system is broken.
In the op-ed titled, “We Can't Have Lower Insurance Premiums and Drug Costs Without Reforming PBMs,” Merritt writes, "Consumers feel the pain of rising costs. Premiums rise. Benefits shrink. Formularies narrow. The inflation families face at the pharmacy counter does not come from drugmakers. It comes from the multilayered system between manufacturers and patients, a system built by and for the middlemen."
As Merritt highlights, while brand-name drug prices increased only 2–5% over the past year, patients' out-of-pocket costs climbed about 35 percent faster. This gap stems from PBMs creating a system to maximize profits at the expense of patients. Through vertical integration, they control the pharmaceutical supply chain, steering patients to higher-cost drugs, imposing barriers to care, and forcing community pharmacies out of business.
The Indiana Pharmacy Association remains a strong advocate for comprehensive PBM reform at both the state and federal levels. One key step forward is the PBM Reform Act, a bipartisan measure introduced by Representative Buddy Carter (R-GA), that would:

• Ban spread pricing in Medicaid, ensuring pharmacies are fairly and adequately reimbursed for their services.
• Delink PBM compensation from drug costs, removing incentives to favor higher-priced drugs.
• Promote transparency for both employers and patients in their prescription drug plans.

“Pharmacists see firsthand how PBM practices impact patients every day,” said Darren Covington, Executive Vice President of the Indiana Pharmacy Association. “When even a former PBM industry leader calls for change, it's clear the time for reform is now. The Indiana Pharmacy Association urges the passage of meaningful legislation that targets rising healthcare costs and safeguards our community pharmacies, ensuring we can continue providing essential care to patients across Indiana.”

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The Indiana Pharmacy Association is the state organization representing the profession of pharmacy in Indiana, optimizing patient care through legislation and innovations in pharmacy practice. Established in 1882, the Indiana Pharmacy Association preserves and advances the interests of the profession and serves the professional needs of pharmacists, student pharmacists, and pharmacy technicians.