Leaders from both parties on the Senate Finance Committee announced on Thursday their plans to push for prescription drug cost reform to be included in the spending bill to fund the Departments of Labor and Health and Human Services.
Finance Committee Chairman Ron Wyden (D-OR) and ranking member Mike Crapo (R-ID) told reporters that they would be asking Senate leadership to include two bills regulating pharmacy benefits managers, or PBMs, middlemen that negotiate drug prices between pharmaceutical manufacturers, insurance companies, and pharmacies.
“The Senate Finance Committee, on a bipartisan basis, isn’t backing down,” Wyden said. “Today, tomorrow, or ever, until we finally get PBM reform in America to help pharmacists and patients.”
Critics of PBMs point out that they earn revenue in part based on the cost of prescription drugs, disincentivizing negotiations for the lowest possible prices. Because PBMs are also often vertically integrated with insurance companies, PBMs are accused of being responsible for the closure of independent pharmacies.
“We have an opportunity hopefully within the next few days to get this legislation over the finish line,” Crapo told reporters.
The Labor-HHS minibus spending bill, which would lock in funding for federal health agencies, is projected to be released over the weekend and is being touted as the last vehicle to pass key health provisions before the 2024 election.
Wyden and Crapo are pushing forward the Modernizing and Ensuring PBM Accountability Act, or MEPA, which the Finance Committee passed by a 26-1 vote last July. MEPA is meant to remove the incentives for PBMs to favor higher-priced drugs over lower-cost biosimilars and increase transparency over the prescription drug supply chain.
The senators also are calling for the addition of the Better Mental Health, Lower-Cost Drugs, and Extenders Act, which the committee unanimously passed last November and builds on MEPA with further reforms to PBMs to cut patients’ out-of-pocket costs at the pharmacy counter. The additional bill would provide greater government oversight and accountability for PBMs.
“We’re going stay at it until it gets done,” Wyden said. “No ifs, ands, or buts, because the longer Congress waits, the more families hurt, the more they have to pony up extra dollars they don’t have.”
In an effort to reduce drug prices, the Biden administration has also taken aim at group purchasing organizations, a different form of pharmaceutical middlemen that purchase pharmaceuticals in bulk from manufacturers to sell to pharmacies and hospitals.
PBM reform has gained some support among Republicans in the House, though the efforts have caused more tension in the lower chamber than they have in the Senate.
Wyden and Crapo hosted Thursday’s press conference in conjunction with the National Association of Chain Drugstores and the National Community Pharmacists Association, strong supporters of PBM reform that would improve competition between national pharmacy chains, such as CVS and Walgreens, and small business pharmacies.
Michelle Belcher, owner of an independent pharmacy in Grants Pass, Oregon, and member of the NCPA, told reporters at the event that national pharmacy chains are incapable of providing the same attentive and personalized care to patients as operators of small businesses.
“Medicine is not healthcare,” Belcher said. “Healthcare is knowing your patients and asking them questions. ‘How are you feeling today, Mrs. Jones? What other medications are you taking?'”
CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER
Wyden said pharmacists are “the ones who really know the patients” compared to physicians who only see each patient once or twice a year.
“The days of stalling are going to end this morning,” Wyden said. “There has been too much delay. Too many reasons for business as usual. The days of bureaucratic hoops and delays are going to end now. And it’s going to be patients, finally, finally, over profits.”
