Medication and cash

NCPA, NACDS commend House committee investigation on PBMs

NCPA and NACDS are praising the U.S. House of Representatives’ Committee on Oversight and Accountability for launching an investigation into pharmacy benefit managers.
Sandra Levy
Senior Editor
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The National Community Pharmacists Association and the National Association of Chain Drug Stores are hailing moves today by the U.S. House of Representatives’ Committee on Oversight and Accountability to launch an investigation into pharmacy benefit managers.

Kicking off the probe, Chairman James Comer, (R-Ky.) is calling on the three largest PBMsCVS Caremark, Express Scripts, and OptumRxto provide documents, communication and information related to their practices that NCPA pointed out “are distorting the pharmaceutical market and limiting high quality care for patients.”

[Read more: AAM report: Middlemen increasingly block patient access to new generics]

Comer also is calling on officials at the Office of Personnel Management, the Centers for Medicare & Medicaid Services and the Defense Health Agency for documents and communications to determine the extent PBM tactics impact healthcare programs administered by the federal government.

In addition to the Federal Trade Commission’s 6(b) study of PBMs and anticompetitive business practices and recent legislative developments in the U.S. Senate, momentum is clearly building in Washington in favor of PBM transparency and reforms. This also follows much state-level action to examine and change PBM practices, NCPA said.

Applauding the start of the investigation, NCPA CEO Douglas Hoey, said, “While PBM-insurer conglomerates have grown even bigger and even richer, patients, employers and small business pharmacies have been left to suffer. After years of work by NCPA and others, the tide in Washington seems to be turning, with this latest investigation and other ongoing efforts offering hope that changes will be coming. NCPA and our members stand ready to assist Chairman Comer and the committee as they work to uncover PBM business practices that increase health care costs and to advance a health care model that better serves their constituents.”

NACDS president and CEO Steve Anderson, said, “NACDS praises the U.S. House Oversight and Accountability Committee for launching in the Committee’s words—an ‘investigation into [PBMs’] tactics that are harming patient care and increasing costs for consumers.’”

Anderson continued, "PBMs are best described as ‘pharmaceutical benefit manipulators’ and their tactics that harm patients, employers, pharmacies and others need to be exposed and stopped. For the well-being of all Americans, chairman James Comer and the Committee will contribute significantly and meaningfully to the bipartisan push to do just that. This investigation needs to focus on prying out the data and the details that will further expose the path to truly comprehensive, effective and lasting PBM reform. They need to ask the right questions and make sure they get the truthful answers. Just as important, the investigation must maintain a wide eye toward anticipating what the PBMs will do next to work around any reforms in an attempt to sustain their profits at the expense of Americans. This extreme problem gets worse with each passing day and swift and total reform is necessary."

Anderson went on to say, “Pharmaceutical benefit manipulators are hired by health insurance plans and others to negotiate lower drug prices. The problem is that they pocket billions while forcing patients to pay more for their medicines, while limiting patients’ ability to choose their pharmacy, while restricting access to the medicines prescribed for patients, and while crushing rural and urban pharmacies. NACDS looks forward to working with the Committee and looks forward to continued work with the other leaders in Congress who are addressing the tactics and the damaging effects of pharmaceutical benefit manipulators. NACDS members were on Capitol Hill this week for this very purpose and we will be there consistently to ensure this job gets done and done completely for the American people.”

[Read more: NCPA survey finds patients disapprove of PBMs]

To access Comer’s letters to the PBMs, OPM, CMS and DHA, click here.