(WASHINGTON, D.C.) – Today, the House Education and Workforce Committee is set to consider the PBM Kickback Prohibition Act, which bars payments from a pharmacy benefit manager (PBM) to a health care broker or consultant. While ostensibly focused on PBMs, in practice the transactions covered by the bill are not kickbacks, but rather common arrangements often included in employer contracts that require a PBM or health plan to cover the fees charged by the brokers or consultants the employer has hired. It is typically the employer, not the PBM, that wants these payments to be made, and under PBM reform acted earlier this year, all such transactions are already required by law to be transparently reported.

In advance of the markup, David Marin, President and CEO of the Pharmaceutical Care Management Association, issued the following statement:

“It is good that lawmakers are beginning to shine a light on the role of benefit consultants and brokers. While PBMs are the most transparent segment of the drug supply chain, these brokers exert enormous influence on all matters of benefit design with almost no oversight. PBMs compete for business based on the bids that these brokers devise, including the pricing, rebate, and fee structures. With this amount of power, employers should have confidence that brokers and consultants are acting in their best interests when soliciting bids from PBMs and other service providers.

“There is much more that should be learned about these opaque players, and we hope that this is just the beginning of the committee taking a broader look at the drug supply chain following the enactment of PBM reform earlier this year.”