Dear Colleague,
It's getting hot. And all of us at NCPA couldn't be happier about it.
I'm not talking about thermometers here. NCPA has kept after PBMs for years, with lots of heat and pressure. But now, we have company. The Federal Trade Commission, the Senate, consumers, physicians, and state legislatures are in our corner, and we're grateful for the company.
On Wednesday, we welcomed a new and powerful ally when Rep. James Comer (R-Ky.), chairman of the House Committee on Oversight and Accountability, announced that his committee has launched an investigation into PBMs and their business practices. Comer has asked the three largest PBMs — CVS Caremark, Express Scripts, and OptumRx — to provide documents, communications, and information by March 15. Comer is asking for a lot of information about discount cards, rebates, contracts, and more. If you want to read the individual letters and specific requests, here they are: CVS Caremark, Express Scripts, and OptumRx. If you don't want to take the time to read the letters, I'll just say that these folks have a busy couple of weeks ahead.
Comer has also requested documents and communications from the Office of Personnel Management, the Centers for Medicare & Medicaid Services, and the Defense Health Agency to determine the extent that PBMs tactics affect health care programs administered by the federal government. Same deadline — March 15.
As you might expect, the PBMs aren't sitting idly by. PCMA, the national association that represents 17 PBM corporations, is pulling out the big bucks (a reported seven figures) for a campaign to share their continued propaganda that PBMs are dedicated to lowering prescription drug costs. Pharmacists and patients have known the brutal truth for a long time that PBMs evolved their business model long ago to benefit from higher prescription drug prices, but others are listening now (hello, Lilly's insulin announcement!). Fortunately, our new allies are organizations that have the power to change things. But attempts to change the pharmacy payment model will be met with intense lobbying pressure. Guaranteed.
With the PBM-insurers digging even deeper into their deep, deep, pockets, critics of PBMs must be relentless with our efforts. Here's some actions for you to take:
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If you live in or around a state capital, be on the lookout for the PCMA campaign propaganda. Their messaging is focused on independent pharmacy store counts—ignoring the thousands of pharmacies PBMs have put out of business and the sickly economic health of thousands of current pharmacies.
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Proactively reach out to your state and federal representatives. Ask your senators to support S. 127, the PBM Transparency Act. They will be pressured to cave on it by big corporations. Don't let them. NCPA believes there will be additional pro-pharmacy, pro-consumer legislation that will be introduced later this year. Commit to contacting your senators and House members once a month for the rest of this year and next to ask for their support. Let them know you were there for them during the pandemic and now you need their vote so they can be there for you.
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Attend NCPA's Congressional Pharmacy Fly-In. Legislators and their staff have heard from you through letters, emails and phone calls, but this is your chance, as health care professionals and constituents, to meet with them face to face. Tell them your story and how PBM practices affect your patients and your business.
The PBMs are sweating. But it's still not hot enough. Turn up the flames to incinerate their unfair business practices.
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
