Pharmacists are hopeful that increased movement by lawmakers to identify the impact of common business practices used by pharmacy benefit managers that contribute to rising drug prices and lack of competition in the supply chain, and the introduction of a new PBM bill that seeks to ban the use of spread pricing in Medicaid managed care programs, will lead to passage of comprehensive PBM reform legislation in the 118th Congress -- whether such bills are advanced alone, combined together, or included as part of a larger legislative package.
Meanwhile, a bill has been introduced that would extend to the private sector a new Medicare policy that requires drug makers to pay back the program when drug prices rise faster than the rate of inflation; and the United States solicitor general is urging the Supreme Court to review a case on generic drug makers’ use of “skinny labeling” to get their products to market. Following the Senate Commerce Committee’s passage of a PBM reform bill last month, Sens. Peter Welch (D-VT) and Roger Marshall (R-KS) on Monday (April 3) introduced the Drug Price Transparency in Medicaid Act (S. 1038), which aims to also improve transparency and protect taxpayers by preventing PBMs from using spread pricing in Medicaid managed care programs. The bill is companion legislation to a House bill of the same name, H.R. 1613, that was introduced last month.
“Stopping PBMs from abusing taxpayer dollars through harmful spread pricing and underwater reimbursements for pharmacies is a priority of NCPA’s. We’re glad to see it’s increasingly a priority among members of Congress,” National Community Pharmacists Association CEO Douglas Hoey said in a statement.
Since January, several efforts have been made either to introduce legislation aimed at lowering prescription drug costs by reforming the operations of PBMs or to gather input on the impact PBM practices have on stakeholders in the drug supply chain and on potential solutions.
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