PCMA Statement on Legislation Introduced in the House of Representatives

(Washington, D.C.) — PCMA issued the following statement on legislation introduced in the House of Representatives:

Legislation introduced in U.S. House of Representatives targeting pharmacy benefits would do nothing to reduce the cost of prescription drugs for patients and would instead hand Big Pharma even more power to rig the system to keep prices high and boost their own profits.

Targeting pharmacy benefit companies puts at risk the outsize value and savings PBMs provide to more than 275 million Americans and the employers, unions, and taxpayers who help fund the health care system. Pharmacy benefit companies are lowering drug costs by $148 billion annually while providing employers, unions, states, and others a variety of coverage choices and flexibility that help them provide affordable, quality Rx coverage.

“Throughout this year as Congress has considered various pieces of legislation narrowly focused on pharmacy benefit companies, we’ve asked the question of whether those bills would do anything to lower drug prices and improve affordability. Unfortunately, when looking at the latest draft legislation in the House, the answer is a definitive ‘no’. Instead of focusing on legislation that risks increasing drug costs, Congress should refocus on enacting policies that promote more competition in the prescription drug marketplace, including policies that eliminate common and egregious drug company practices aimed at extending patents in highly anti-competitive ways,” said JC Scott, PCMA President and CEO.

Singling out PBMs is further confounding given pharmacies benefit companies make up six percent of the prescription drug dollar while drug companies keep 65 percent.

A new report, “Understanding the role of PBMs in the US Drug Pricing Debate,” released today by Alex Brill of Matrix Global Advisors, examines how and why PBMs function and provide value, and cautions that targeting PBMs’ incentives and ability to negotiate lower prices with manufacturers could result in higher total drug spending.

“Polls show that voters are concerned with the affordability of healthcare, but policymakers seem distracted by policies limiting the functionality and flexibility of those tasked with pharmacy benefit design,” said Brill. “Proposals aimed at PBMs — such as delinking or a ban on spread pricing—do nothing to address drug prices and may raise pharmaceutical spending overall. Congress should focus on policies that encourage competition among drugmakers if the objective is to tame spending.”

Pharmacy benefit companies are strong proponents of transparency and provide information and data to employers and government agencies that patients, their providers, plan sponsors, and policymakers need to make informed decisions about prescription drug products, coverage and costs.

The transparency provisions in the legislation would severely undermine the ability of pharmacy benefit companies to negotiate lower drug prices by publicly disclosing drug company price concessions, inviting drug companies to collude with their competitors to discount less deeply, and drive drug prices even higher.

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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.