PBM reform push heats up
Nov 12, 2024
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The Big Story PBM reform push heats up Congress is facing pressure from outside groups to consider legislation to reform the pharmacy benefit manager (PBM) industry during the lame duck period.© AP
PBM reforms have bipartisan backing, and the lame duck session between the election and the end of the year is one of the final opportunities to take advantage and pass legislation to rein in the middlemen of the prescription drug supply chain.
A full suite of new ads — part of a seven-figure campaign from PhRMA that includes national news outlets and digital and social media channels — urges lawmakers to make sure savings from PBMs go directly to patients.
Drugmakers argue PBMs are the reason prescription drugs are so expensive. PBMs negotiate the terms and conditions for access to prescription drugs for hundreds of millions of Americans. They are responsible for negotiating prices with drug companies, paying pharmacies and determining which drugs patients can access and how much they cost. Legislation aimed at PBM practices passed the House and a Senate committee last year but failed to be included as part of a spending deal in March.
And it’s not just the drug industry. Another ad campaign launched Tuesday by the National Association of Manufacturers calls on Congress to “institute comprehensive PBM reform that increases transparency into these underregulated actors and limits their outsized control over the prices patients pay at the pharmacy counter.”
Nearly 100 health care and consumer advocacy organizations also signed a letter Tuesday to congressional leadership calling for “strong pharmacy benefit manager (PBM) transparency and accountability reforms.”
Among the groups that signed the letter were the American Kidney Fund, American Liver Foundation, Biosimilars Council, HIV+Hepatitis Policy Institute and the National Consumers League.
“To date, seven committees of jurisdiction across both chambers have voted overwhelmingly in favor of PBM transparency and reforms (in some instances voting unanimously or nearly unanimously to advance these policies),” the letter stated.
“Now is the time to enact real and lasting change. Congress must not squander the opportunity for real change impacting real lives and must enact these reforms this year.”
Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel, Joseph Choi and Alejandra O'Connell-Domenech — every week we follow the latest moves on how Washington impacts your health.
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