Pharmacy benefit managers will be required to report more information about their dealings with pharmaceutical companies under legislation passed unanimously by the House panel on Wednesday.
The House Energy and Commerce Committee promoted the Critically Needed (Patients) Access to Treatment and Transparency Enhancement Act of 2023, sponsored by Chairman Cathy McMorris Rodgers (R-Wash). .) and senior member Frank Pallone (DN.J.), on a 49-0 vote. Council Health Subcommittee delete the same measure last week.
“This measure would tell patients how much they would pay for care, who owns their doctor’s office, and how much administrators pay,” McMorris Rodgers said during committee discussions. pharmacies earn from their drugs”.
The measure would require PBMs to generate reports for employer customers each year detailing prescription drug spending, purchase costs, out-of-pocket costs, drug formulary, and discounts. In addition, the Government Accountability Office will issue a report on pharmacy networks under group health plans, including those owned by health insurers.
PBM is under pressure in Washington as policymakers seek to address rising prescription drug prices.
In addition to legislation by the Energy and Commerce Committee, the House Oversight and Accountability Committee open an investigation into PBM business practice in March. In the Senate, the Committee on Health, Education, Labor and Retirement passed a bipartisan bill this month will go beyond the House measure by prohibition of price difference and require PBMs to pass on drug manufacturer rebates to customers and patients, disclose the price they negotiate for the drug, disclose the fees they pay to pharmacists for dispensing prescriptions, and report number money they earn from drug manufacturer rebates.
These congressional efforts coincide with executive actions. On Tuesday, the Centers for Medicare and Medicaid Services publish a proposal require PBMs to disclose the prices they pay for drugs under Medicaid. And the Federal Trade Commission this month expand the area its lasts all year PBM . investigation such as CVS Health’s CVS Caremark, UnitedHealth Group’s OptumRx, and Cigna’s Express Scripts to include group purchasing organizations affiliated with those companies.