Pharmacy Benefit Managers

Bernard W. Smalley

Anapol Schwartz

Date:

Duration: 4:56

Bernard Smalley describes his areas of work, specifically pharmacy benefit managers.


Video Transcript

[introductory music]

Hello, my name is Bernie Smalley. I'm an equity partner here at Anapol Schwartz. I'm proud to say that I'm entering my 20th year as a member of the firm. I'm also proud to say that I was born and raised here in west Philadelphia, and I still live here with my family. I want to talk to you about the practice areas that I've been involved with at the firm over the last 20 years, primarily medical negligence, large personal injury cases, and defamation and slander.

Defamation and slander occurs when someone or the media says something about you that is untrue, which tends to ruin your reputation. But I also want to talk to you about something, a new area I'm involved with. It's called PBM, or pharmacy benefit manager litigation.

Over the past 20 years, I've been involved in a number of different practice areas, principally medical negligence, personal injury, as well as defamation and slander. Defamation and slander occurs when an individual or a media or newspaper or television station does in fact say something that is inappropriate or untrue, which tends to ruin your reputation, both in the public and in your general community.

That's what I've been doing over the last 20 years. I want to talk to you about something else, a new product or a new area that I've been involved in over the last two years and that's pharmacy benefit manager litigation, or PBM for short. Do me a favor, reach into your wallet, this will only take a second. Pull out your pharmacy card, the drug card you use when you go up to the counter and you pay for your prescriptions that have been prescribed by a physician. Flip it over, take a look at the back. In all likelihood, you will see the following on the back of the card: Advanced PCS, Caremark, Express Scripts or Merck Medco. That happens to be your particular PBM.

PBM's represent pharmacy benefit managers. That's what it stands for, and they are in fact useful administrative tools that stand in the middle, between the pharmacies that ultimately dispense the drugs and the manufacturers who produce the drugs. And they are supposed to provide the maximum benefit to you and to your employer or to your union plan by getting you prescriptions at the lowest possible price.

That's what they're supposed to do. That's the fantasy; that's not the reality. The reality is that they have kept to themselves hidden profits in the form of rebates that should come to you, your employer, or your union plan. They have kept incentive dollars, given to them by manufacturers to produce or to push a particular medication or a particular drug. They have kept those things for themselves. And where there have been pricing differences for the same particular generic medication, you have paid the highest cost, where they have reaped the highest profit for themselves.

I have extensive experience in this area, which has occurred, certainly over the last three and a half years, by using experts who used to work in the PBM industry, some people call them insiders, who got fed up with the practices they saw, came to us, told us about them, and they are now retained as our experts. That's been my biggest source of information, my biggest source of experience. And frankly, there can be none better -- these are the people who were on the inside. They know what took place, they saw what took place, and now we are using their intelligence and their knowledge to fight back those PBM's who control 75% of every prescription ever made in the United States.

At this time in America, when the cost of prescription drugs is rising at an astronomical rate, this is an opportunity for us to put back in the hands of you, your employer, or your union those dollars which you should have received in the first place, that have been wrongfully hidden and kept by the PBM's. That's what our firm is engaged in. That's what the consortium of law firms is engaged in. That's my responsibility to you, and I'd like to have the opportunity to fulfill it.

[closing music]

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