During a recent government meeting, officials discussed the challenges and opportunities surrounding the implementation of an international pharmacy program aimed at reducing medication costs. Currently, the program is voluntary and primarily applicable to a small percentage of brand-name and biosimilar drugs, which represent only about 10% of the overall pharmacy spend. The remaining 91% consists of generic medications, which are not eligible for international filling due to favorable pricing domestically.

Despite the potential savings for the county, uptake of the international program has been low. Officials emphasized the need for ongoing education and promotion to encourage members to utilize the program, which allows them to fill prescriptions at no cost. Integration with the Healthjoy app is being explored to facilitate access and information about the program.

The discussion also highlighted broader issues within the pharmaceutical industry, including the high costs of drug development and the role of Pharmacy Benefit Managers (PBMs). It was noted that the U.S. pays significantly more for medications compared to other countries, with recent statistics indicating that the cost to develop a drug can range from $2.3 billion to $4.6 billion. The meeting underscored the importance of legislative action to address these disparities and the need for smarter consumer choices to manage rising healthcare costs.

Officials acknowledged the complexity of the pharmacy landscape, where a few major PBMs control a significant portion of the market, complicating efforts to negotiate better prices. The conversation concluded with a call for continued advocacy and strategic planning to navigate these challenges effectively.