Pharmacy orgs praise House passage of bipartisan bill to deliver PBM reforms
Pharmacy organizations, including the National Association of Chain Drug Stores and the National Community Pharmacists Association, applauded the passage late Monday of the Lower Costs, More Transparency Act (H.R. 5378) by the U.S. House of Representatives.
The bill, which was introduced by U.S. Representative Cathy McMorris Rodgers (R-Wash.) on Sept. 8, is a vital aspect of pharmacy benefit manager reform. Among its provisions, it addresses the “pharmaceutical benefit manipulation” that harms the most vulnerable in Medicaid, NACDS noted.
“House passage of the Lower Costs, More Transparency Act is a major step toward achieving real and comprehensible PBM reform that includes the most vulnerable in Medicaid and Medicare,” said Steve Anderson, president and CEO of NACDS. “NACDS thanks U.S. Representatives Cathy McMorris Rodgers (R-Wash.), Virginia Foxx (R-N.C.), Jason Smith (R-Mo.) and Frank Pallone (D-N.J.) for their bipartisan leadership in bringing this important bill to the full House for a vote."
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Anderson continued, “We also appreciate U.S. Representatives Buddy Carter (R-Ga.), Vicente Gonzalez (D-Texas), Elise Stefanik (R-N.Y.), Deborah Ross (D-N.C.), Rick Allen (R-Ga.) and Jake Auchincloss (D-Mass.) for their bipartisan commitment to crack down on tactics by which pharmaceutical middlemen maximize profits at the expense of people, pharmacies and others.”
Carter, Gonzalez, Stefanik, Ross, Allen and Auchincloss were the original co-sponsors of the NACDS-backed Drug Price Transparency in Medicaid Act – whose provisions were included in the newly passed bipartisan bill.
Anderson also emphasized the need to ensure PBM reform for all Americans, stating, “Overall, NACDS is advocating for comprehensive PBM reform across all payer segments, consistent with NACDS’ Principles of PBM Reform. At the federal level, it is imperative that Congress acts swiftly on the fact that real PBM reform includes Americans in the Medicaid and Medicare programs, and the pharmacies that serve them."
NACDS also urges support for other legislation related to Medicare and Medicaid that is the bipartisan work product of the House Energy and Commerce Committee. Further, NACDS urges support for H.R. 5400, the Neighborhood Options for Patients Buying Medicines (NO PBMs) Act and vital enforcement provisions, the Senate versions of which have advanced unanimously through the Senate Finance Committee.
NACDS said it appreciates the bipartisan collaboration and work across the two chambers to deliver meaningful reform and urges the Congress to finish the job.
[Read more: Reforming PBM practices]
NCPA issued the following statement on Monday from Anne Cassity, senior vice president of government affairs, as the House of Representatives prepared to vote on the legislation:
“Community pharmacy has been pushing consistently for the last 15 years for transparency into PBM operations and reforms to their tactics. During that time, care has only grown more difficult for patients to afford and to access and for pharmacies to provide. This legislation would help provide desperately needed relief while also saving taxpayer resources, prohibiting spread pricing and seeing that pharmacies are paid in a way that would cover their dispensing costs. We’re grateful to our allies in Congress for keeping PBM reforms on their agenda and are eager to see these and other changes enacted as quickly as possible.”
Cassity added, “H.R. 5378 is NCPA-priority legislation that follows a months-long process to combine efforts of the House Energy and Commerce, Ways and Means, and Education and the Workforce Committees into a single legislative package. It includes the Drug Price Transparency in Medicaid Act (previously H.R. 1613), which would bring greater transparency to the Medicaid program, save taxpayers more than $1 billion over 10 years, and provide fair and transparent reimbursements to pharmacies. It also prohibits spread pricing/requires a full pass-through in all Medicaid managed care programs; requires pharmacy reimbursements in all state Medicaid managed care programs be at a rate of pharmacy’s average acquisition costs and the state’s Medicaid fee-for-service dispensing fee; limits payments to pharmacy benefit managers to solely administrative fees; and creates savings for taxpayers.”