1. Contact Local Officials to Demand Transparency

    There is legislation in Congress which would help tackle this by forcing PBMs to disclose “rebate” and “discount” data. Contact your representatives and demand transparency.

  2. Get involved locally

    There are bills being passed and debated in most states about wasteful or unfair practices from pharmaceutical benefit management. Contact advocacy groups to see how to get involved.

  3. Find Out What Companies Are In Charge Of Your Appeals

    The large PBMs rely on various Internal Review Organizations (IRO) which exist to handle appeals on behalf of a client. Make sure to find out which organizations were part of the appeal process and look to see if they made any errors in processing yours.  

  4. Exhaust Your Appeal Options

    Continue to advocate for yourself in the appeals process, which can vary depending on one’s health plan or PBM. Maintain your records; they could prove useful. Patients can also file complaints at state medical boards.

  5. Follow the money

    You can track the political donations and lobbying activities of PBMs via open data resources like the Center for Responsive Politics. Find out what legislation they are pushing and where they spend their resources in Washington D.C.

  6. Tell Tarbell About Your Experience With PBMs

    Have you battled your PBM over a prescription denial or experienced another struggle with your PBM? Please take Tarbell’s survey on PBMs.