Input Stories

A bipartisan group of legislators took an important step Tuesday in the fight for reform of pharmacy benefit managers.

What’s going on: Rep. Mariannette Miller-Meeks (R-IA) was joined by Reps. Nanette Barragan (D-CA), Nicole Malliotakis (R-NY), Donald Norcross (D-NJ), Brad Schneider (D-IL) and Rick Allen (R-GA) in reintroducing the NAM-backed Delinking Revenue from Unfair Gouging (DRUG) Act. (The NAM has led the charge in advocating for PBM reform.)

• The measure would require PBMs—underregulated middlemen that dictate what patients pay at the pharmacy counter—to “delink” their compensation from medication list prices, ensuring that they charge flat rates for their services instead of taking a percentage of the list price as profit.
• This move would eliminate PBMs’ incentive to exert upward pressure on drug costs.

Why it’s important: “PBMs increase health care costs by driving up prescription drug list prices, forcing patients to pay more at the pharmacy counter and making it more difficult for manufacturers to offer affordable health care benefits,” NAM Managing Vice President of Policy Charles Crain said in a statement cited by Rep. Miller-Meeks.

• The DRUG Act “will rein in PBMs operating in the commercial market by removing their perverse incentive to maximize their own profits at the expense of manufacturers and manufacturing workers.”

The final say: PBMs “have excessive influence over the prices patients pay at the pharmacy counter,” said Rep. Miller-Meeks, adding that “pharmacies are closing due to greedy PBM practices impacting proximity and access to medications.”

• “I hear all too often from constituents telling me how they are forced to ration their medicines—even cutting their pills in half—or foregoing their medication all together due to skyrocketing costs,” Rep. Schneider said. “We must address the drug affordability crisis in America, and that requires addressing the role of pharmacy benefit managers.”