Now that the governors of Maine, New Hampshire, and Vermont have agreed to form a prescription drug-buying cooperative, the hard work of fleshing out the plan begins. State health and insurance officialswill hire a pharmacy benefit manager to buy drugs and manage utilization. The group plans to solicit proposals from PBMs next month.
Political pressure to reduce out-of-pocket expense for people with minimal or no prescription coverage is intense in the three states, where there has been national publicity about pharmaceutical-buying expeditions to Canada.
But a lot of details must be worked out, and who gets what is likely to be the stuff of political theater. Who would benefit is unclear. The states would probably start with Medicaid, but in theory, the PBM could manage benefits for everyone.