What Problem is Congress Trying to Solve?

(Washington D.C.) – The Pharmaceutical Care Management Association released the following statement on today’s votes in the Senate Finance Committee and the Ways and Means Committee:

Today, as two congressional committees vote on legislative proposals under the guise of lowering prescription drug costs, it’s time to ask the question: What problem is Congress trying to solve? If the goal is to lower drug costs for patients, taxpayers, and employers, these bills focused on pharmacy benefit companies and others approved this year by several committees, would not meet that goal. In fact, each bill would risk cuts to pharmacy benefits and increased drug costs.

Unfortunately, the legislation being considered by the Senate Finance Committee and the legislation before the House Ways and Means Committee ignore the profound statutory and regulatory changes to the Medicare Part D program that are yet to be implemented due to the Inflation Reduction Act, including an out-of-pocket spending cap and new rules on cost sharing, and the uncertain and likely significant impact they may have on beneficiary premiums. The Finance bill also takes a dramatic step back from value-based payment arrangements to fee for service, at a time when CMS and private payers are encouraging rewarding value.

Regarding the House Ways and Means Committee vote, the legislation benefits Big Pharma by weakening pharmacy benefit companies’ ability to lower costs for drugs that already have patent protections and monopoly pricing. In addition, pharmacy benefit companies practice and support transparency that empowers patients, physicians, employers and health plan sponsors to make the best decisions to lower prescription drug costs for patients.

Plan sponsors receive information on all contract terms, including how PBMs are paid for their services and negotiated rebates. Further, government regulators, such as CMS for Medicare Part D, already receive voluminous and detailed information on price concessions, costs, and service fees. Pharmacy benefit companies promote and have offered to work with Congress on actionable transparency that includes appropriate guardrails to avoid disclosure of specific price concessions and proprietary information that drug companies would almost certainly use to increase the costs of prescription drugs.

We urge Members of Congress to redirect their attention to legislation that would actually lower drug prices for Americans, rather than pad the bottom lines of drug companies.

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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.