Will new Senate bill curb the power of the PBMs - and drive down drug costs?
The Senate Finance Committee, which has jurisdiction over Medicare, introduced a bipartisan bill on Thursday – the latest move by Congress to rein in pharmacy benefit managers by creating independent audit efforts.
A bipartisan bill introduced on Thursday is the latest move by Congress to rein in pharmacy benefit managers. Sens. Ron Wyden, R-Ore., and Mike Crapo, R-Idaho, the chair and ranking member of the Senate Finance Committee, formally introduced the Modernizing and Ensuring PBM Accountability Act, or MEPA.
The committee, which has jurisdiction over Medicare and Medicaid, overwhelmingly approved the bill in July. The legislation would:
- Prohibit PBM compensation in Medicare from being tied to price;
- Increase audit and enforcement measures; and
- Aid independent community pharmacies that have struggled because of PBM practices.
The bill also calls for a survey of retail community pharmacy drug prices to determine the national average drug acquisition cost for covered outpatient drugs. It would include price concessions to the pharmacy, such as discounts and rebates.
“Today’s introduction marks the next step toward taking on health-care middlemen that are driving up costs for seniors and taxpayers,” Wyden said. “Sen. Crapo and I are committed to continuing our work with members of the committee who are interested in including additional policies beyond those in this bill. I look forward to continuing our work, passing this into law and curtailing the PBM practices that are keeping drug prices high.”
Legislators have introduced at least a dozen bills so far this year that would address the impact of increasing consolidation among PBMs and lack of transparency into prescription drug access and pricing. The Pharmaceutical Care Management Association, the trade association representing PBMs, contends that none of the legislative proposals would lower drug prices.
“Instead of focusing on legislation that risks increasing drug costs, Congress should refocus on enacting policies that promote more competition in the prescription drug marketplace, including policies that eliminate common and egregious drug company practices aimed at extending patents in highly anticompetitive ways,” Greg Lopes, assistant vice president of strategic communications, told The Hill.
Related: PBMs – and pharma – draw bipartisan fire in House Oversight Committee hearing
Organizations supporting MEPA include the Alliance for Transparent and Affordable Prescriptions, the Alliance of Community Health Plans, the Coalition of State Rheumatological Organizations and the National Community Pharmacists Association.
“The comprehensive proposals included in this bill will enhance oversight of PBMs and improve incentives across Medicare and other federal health programs,” Crapo said. “Moving forward, we will continue to build on this foundation through additional priorities from senators across the finance committee to promote pharmacy access, strengthen accountability and reduce out-of-pocket costs for patients.”