PBMs under fire again as Senate introduces new bill

Following a Senate Finance Committee markup hearing in July, where members voted 26-1 in favor of the Modernizing and Ensuring PBM Accountability (MEPA) Act, Senators Ron Wyden, D-Oregon, and Mike Crapo, R-Idaho, formally introduced the bill on Thursday.

Designed to curb the power of pharmacy benefit managers, the bill would prohibit PBM compensation in Medicare from being tied to the price, increase audit and enforcement measures and aid independent community pharmacies that have struggled because of PBM practices, according to a news release.

“Today’s introduction marks the next step towards taking on health care middlemen that are driving up costs for seniors and taxpayers,” said Wyden in a statement. “Senator Crapo and I are committed to continuing our work with members of the committee who are interested in including additional policies beyond those in this bill. I look forward to continuing our work, passing this into law and curtailing the PBM practices that are keeping drug prices high.” 

“This commonsense, bipartisan legislation takes crucial steps toward driving down prescription drug costs for Idahoans and ensuring that seniors can access the pharmacy of their choice, including in rural communities,” said Crapo.

MEPA is supported by the Alliance for Transparent and Affordable Prescriptions, the Alliance of Community Health Plans, the Coalition of State Rheumatological Organizations, the National Community Pharmacists Association, patient groups and more.

July’s hearing discussing reining in PBMs was met with bipartisan agreement. Among the provisions in the bill members desired included banning spread pricing, stopping PBMs from receiving payments Medicare Part D covered drugs and providing the Centers for Medicare & Medicaid Services $20 million in funding. Approximately $1.726 billion in savings to the Medicare Improvement Fund would also be set aside.

The National Association of Chain Drug Stores is supporting the legislation, saying it confronts "pharmaceutical benefit manipulation" and reforms the middlemen acting in their own self-interest.

The bill also says a survey will be conducted of retail community pharmacy drug prices to determine the national average drug acquisition cost for covered outpatient drugs. It would include price concessions to the pharmacy, including discounts and rebates.

An Office of Inspector General report would be commissioned to study “the impact of related party transactions within select vertically integrated entities on the negotiated price paid by part D plan sponsors,” the bill reads.