Lawmakers At Hearing Hope To Shine Light On Opaque, Mysterious Inner Workings Of Pharmacy Benefit Managers
Congress is expected to grill executives from these middlemen companies that have absorbed much of the blame for rising drug prices. "They're kind of a secret organization," says Sen. Chuck Grassley (R-Iowa). "I ask people to explain what they're doing and nobody seems to give you the same answer twice." Grassley is chairman of the Finance Committee and Tuesday's hearing is the panel's third on drug prices this year. Meanwhile, it's not just Congress that's investigating the role of PBMs in the drug cost issue -- states are getting in on the action as well.
NPR:
Senators Set To Grill PBMs About Drug Costs
Consumers, lawmakers and industry players all seem to agree that prescription drugs prices are too high. What they can't always agree on is whom to blame. On Tuesday, though, fingers are expected to point toward pharmacy benefit managers, the industry's mysterious middlemen. The Senate Finance Committee will hear from executives from the biggest pharmacy benefit managers, led by CVS Caremark and Cigna's Express Scripts. (Kodjak, 4/8)
Kaiser Health News:
Consumers Rejected Drug Plan That Mirrors Trump Administration Proposal
Unraveling how much of a prescription drug price gets swallowed by “middlemen” is at the forefront of Tuesday’s drug price hearing in the Senate. One thing bound to come up: rebates. Both major political parties have shown interest in remedying high drug prices, and drugmakers have bemoaned how rebates to middlemen keep them from reaping every dollar associated with those price tags. (Lupkin, 4/9)
Bloomberg:
Drug Middlemen Face State Probes Over ‘Complex’ Pricing System
Several states are probing pharmacy-benefit managers’ business practices in government-sponsored health programs, adding to the scrutiny the middlemen face in Washington for their role in the cost of drugs. At least three state attorneys general are investigating PBMs, in addition to other state probes looking into how the companies contract with Medicaid and other programs. CVS Health Corp., Cigna Corp.’s Express Scripts unit and UnitedHealth Group Inc., which dominate the PBM market, are scheduled to appear before the Senate Finance Committee in Washington Tuesday to discuss their role as the nation grapples with soaring drug prices. (Langreth, 4/9)
And in other pharmaceutical news —
Modern Healthcare:
Change Drug Rebate Rule To Keep Drugmakers Honest, Hospitals Urge
Insurers and hospitals want the CMS to amend its proposed rule eliminating the safe harbor for Medicare Part D and Medicaid managed-care drug rebates to include new requirements for drugmakers. In comments on the proposed rule, several companies and groups expressed concern that the change eliminating the safe harbor for rebates and replacing it with a safe harbor for point-of-sale discounts won't force drugmakers to lower prices. In addition they said implementing the changes in January 2020 would be too soon. (King, 4/8)
