Congress is not off to a smooth start. But one of the most likely areas for bipartisan action when the House gets its action together is he PBM. as we reported Tuesday.
- So how does PBM deal with this scrutiny? Industry sources recognize that they need to do a better job of educating members of Congress on what PBMs actually do, and they are the ones who are actually working on low-cost negotiations in the supply chain. It is said that
Behind the scenes: Notably, PBM is not planning a major counterattack against PhRMA, which has targeted PBM.
- Participating in circular firing squads between industry groups would not be productive for anyone and would only require the government to intervene in regulation, PBM officials said.
- JC Scott, CEO of the Pharmaceutical Care Management Association, a PBM trade group, told Axios that “blame tactics” across the supply chain are not productive.
- “It has collectively undermined confidence in the private market system to the extent that Congress has become dysfunctional and has realized it needs to intervene,” Scott said. “We should all move away from that pointing strategy.”
- When asked to respond, PhRMA spokesperson Brian Newell said, “We must work together on a solution that spans the entire healthcare system.” It has to include addressing the fact that you are paying for the drugs,” he added. Their PBM and health insurance will pay. ”
So what are PBMs doing if they aren’t attacking? In addition to reaching out to lawmakers, the PCMA will release its own policy proposals on drug costs “within the next two weeks,” Scott said.
- These will focus on ways to promote biosimilar adoption and promote competition by cracking down on “patent abuse.”
By numbers: The PCMA has increased lobbying funding in recent years, from $4.25 million in 2019 to $7.8 million in 2021, the last year available. according to Open your Secrets data. Still well below his PhRMA of $30.41 million. Spent 2021 years.
- “Advertising, media, grassroots engagement, advocacy, all of that, the sector is definitely stepping up its efforts,” said a PBM industry source, noting that PBM is not even trying to match the amount of money pharma spends. I admitted that
What we see: It is not yet clear which bill is the most likely or the greatest threat, according to PBM sources. Global dysfunction and fragmented governments can make major health policy actions difficult.
- Another PBM industry source said, “We are certainly monitoring all bills. Is it a concern? Always. But is it a panic? No.”
- Senator Chuck Grassley and Rep. Maria Cantwell, for example, are bipartisan. measures to take measures For example, it is like prohibiting PBM from using “spread pricing”. In this case, you charge your health insurance more than you pay the pharmacy for the medicine and keep the difference.
- Ron Wyden is C-through methodThis includes requiring PBMs to pass on a minimum percentage of rebates to health insurance.
- Other proposals focus on transparency and require PBMs to disclose more information.
What they say: “In my opinion [PBMs] Pharmaceutical companies suffered so badly with the IRA that they have a bit of a target on their shoulders for 2023,” said Joe Grogan, a former Trump administration health official who consults for both pharmaceutical companies and PBM. increase.
- “So, right after they beat the pharma companies, where are they going next? And the next industry they don’t understand is PBM, and that’s where they’re going.”
