St. Louis Reporter

Rita Numerof, president of Numerof and Associates consulting group, said pharmacy benefit managers (PBMs) have increased costs for patients. 

"Employers have a complex relationship with PBMs," Numerof said in a post on X. "These drug pricing middlemen should create value, but their opaque business practices raise out-of-pocket costs for health plan members."

Numerof recently penned an op-ed published by Forbes which detailed the disconnect between patients and reduced costs created by PBMS. "One concern is the lack of transparency in pricing and rebates," she wrote. "Employers are kept in the dark about the true costs and savings, making it difficult to assess whether PBMs are delivering on their cost-containment assurances."

A PBM is a third-party administrator of prescription drug programs for health insurers, self-insured employers, and government agencies. PBMs negotiate with drug manufacturers to secure discounts and rebates on medications, manage pharmacy networks, and process prescription drug claims. PBMs also provide services such as medication therapy management and mail-order pharmacy services.

The Federal Trade Commission (FTC) has released an interim staff report on the prescription drug middleman industry. According to an FTC press release, the interim report, required by a special order issued by the FTC in 2022, outlines how increased vertical integration and concentration have contributed to the rise of six PBMs that now manage almost 95% of the nation’s prescriptions.

The FTC asserts that this vertical integration and concentration have led to PBMs profiting at the expense of patients and independent pharmacists. "The FTC’s interim report lays out how dominant pharmacy benefit managers can hike the cost of drugs—including overcharging patients for cancer drugs," FTC Chair Lina M. Khan stated in the press release. "The report also details how PBMs can squeeze independent pharmacies that many Americans—especially those in rural communities—depend on for essential care."

NAI Consulting, based in St. Louis, was founded by Rita Numerof. The firm supports clients in the global healthcare industry on a range of topics including pharmaceutical, medical device and diagnostics companies. 

Numerof attended Honors College, Syracuse University and received her PhD from Bryn Mawr College. She had published six books and currently serves as an adjunct faculty member at Olin School of Business at Washington University in St. Louis.