In case you missed it, Jason Altmire, former Democratic three-term U.S. Representative from Pennsylvania and current adjunct professor at Texas Tech University, explains why so-called “delinking” proposals would be catastrophic for patients and families’ pocketbooks in a new op-ed in RealClearHealth.
Altmire explains how current market-based payments secure savings and incentivize better performance:
“We have all encountered that lazy co-worker who stinks at his job but gets the same salary as everybody else. That happens a lot and it probably rankles you. The more appropriate and efficient system occurs when compensation is linked to performance. People work harder and better when they get compensated to do so. It’s not complicated. But sadly, some lawmakers don’t seem to understand this when it comes to your healthcare costs…
“Currently, PBMs are paid by health plans based on how effectively they secure savings from drug companies and pharmacies. This is called pay for performance and it’s a good thing. But the Senate plan would “de-link” PBM compensation from the drug price, which would result in increasing costs.”
He goes on to provide a detailed explanation on how “delinking” would shift billions of dollars from patients into the pockets of Big Pharma:
“Billions more public and private dollars would go to Big Pharma and their allies. This legislation ignores the fact that list prices for medications are completely at the discretion of pharmaceutical manufacturers, who raise or lower them for their own reasons. The fact is that PBMs and their buying power are the only real check on drug companies’ otherwise unlimited pricing power – which is precisely why those drug companies oppose them…
“Inexplicably, the de-linking bill excludes all those other entities that are compensated based on list price and applies exclusively to the only link in the chain that gets paid to save their customers money. So why would Congress take this nonsensical approach? Perhaps the $20 billion Big Pharma has spent on lobbying so far this year has something to do with it.”
Former Representative Altmire joins former Republican U.S. Senator Pat Toomey in cautioning lawmakers against passing proposals targeting pharmacy benefits. Sen. Toomey wrote in a recent op-ed in Townhall:
“The proposals targeting PBMs aim to eliminate PBMs’ ability to earn a percentage of the savings they negotiate and/or force PBMs to disclose negotiated prices in business-to-business transactions. These measures would reduce PBMs’ capacity to generate savings in future negotiations.”
Learn more about what health policy researchers Alex Brill and Casey Mulligan had to say on the costly implications of “delinking” legislation HERE.
See a recent op-ed from PCMA president and CEO JC Scott sharing how recent Congressional proposals would increase premiums HERE.
Read why Joe Grogan, visiting senior fellow at the USC Schaeffer Center and former domestic policy adviser under the previous administration, is also sounding the alarm over “delinking” legislation HERE.
PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 275 million patients. Learn more at www.pcmanet.org