Experts from across the healthcare system weighed in on several House bills aimed at increasing transparency in the pharmaceutical supply chain at a hearing Tuesday.
Seven pieces of legislation, all of which are bipartisan, were on the slate for discussion at the House Energy and Commerce Committee Subcommittee on Health hearing. Amid the political fervor over rising drug prices, shining a light on how prices are determined has been a key focus for policymakers.
However, some in the industry warn that there may be too much of a good thing and that making all data public could undermine the goal of bringing down costs. Kristin Bass, chief policy and external affairs officer for the Pharmaceutical Care Management Association (PCMA), said the group backs releasing data on rebates and negotiations in “aggregate.”
But the pharmacy benefit management (PBM) trade group fears that fully public data would prevent effective negotiation with drug companies, Bass said.
“We have issues around public reporting when it would allow for tacit collusion” among drugmakers, she said.
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Mark Miller, executive vice president of healthcare at Arnold Ventures, said greater transparency could “compel the issue forward.” However, on its own, transparency isn’t going to revolutionarily change how drugs are priced, he said.
None of the bills in question for Tuesday’s hearing would have forced PBMs to publicly disclose individual rebates negotiated for specific drugs, though one would make them release the data in aggregate.
Bass said that PCMA would recommend policymakers release such data by class for those with at least three drugs. It also suggests a lag time of several years for the data to be published to allow PBMs to adjust to existing contracts.
The ongoing debate on whether to eliminate rebates negotiated by PBMs entirely from the system was also on the slate at the hearing. Legislators pushed back on the fact that some PBMs will put drugs with higher list prices on the formulary instead of lower-cost alternatives.
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Bass said insurers select drugs with the lowest net price—the price after rebates and other discounts have been factored in—and often that’s the drug with the higher list price.
Eliminating rebates, she said, would not put pressure on drug companies to lower list prices on their own, a point that others in the insurance industry have also noted. Studies have also suggested that the Trump administration’s plan to do so in Part D would increase premiums and taxpayer spending.
That said, the industry should indeed be looking at the concerns raised by rebates’ critics, she said.
“We do think there is a conversation to be around the price concessions,” Bass said.