NCPA Urges Policymakers to Further Probe PBM Black Box

NCPA May 5, 2022

ALEXANDRIA, Va. (May 5, 2022) – Greater federal scrutiny over pharmacy benefit managers’ business tactics is imperative for patients, small business pharmacies, and taxpayers, the National Community Pharmacists Association said in a statement for the record for a hearing on ensuring fairness and transparency in the prescription drug market. The hearing is being held today by the U.S. Senate Commerce Committee’s Subcommittee on Consumer Protection, Product Safety, and Data Security. The subcommittee is led by Chair Richard Blumenthal (D-Conn.) and Ranking Member Marsha Blackburn (R-Tenn.).

After detailing how PBMs harm the marketplace with anticompetitive practices – including patient steering, discriminatory reimbursement, and overly broad audits, among others – NCPA’s comments urge policymakers to take action to lower out-of-pocket costs for patients, provide certainty for small business pharmacies, and protect taxpayers by bringing more transparency to the PBM/health insurer marketplace. The comments specifically encourage passage of S. 1388, the Prescription Pricing for the People Act, and S.298, the Pharmacy Benefit Manager Accountability Study Act. NCPA also reiterates that the Federal Trade Commission should proceed with conducting a 6(b) study on PBMs’ commercial activities for better insight into their drug pricing practices and their contracts with pharmacies.  

“Egregious PBM-insurer practices have flown under the radar for too long, and we’re glad they’re getting the scrutiny they deserve,” said Karry La Violette, NCPA Senior Vice President of Government Affairs. “The truth is that PBM-insurers manipulate the system to their benefit. They’ve created a perverse environment where one competitor sets another competitor’s prices, dictates competitors’ reimbursements, uses competitors’ data to steer patients to their own retail, specialty and mail-order pharmacies, and limits where and what consumers can buy. These anticompetitive practices should continue being exposed and prohibited. We appreciate Chair Blumenthal and Ranking Member Blackburn for holding this hearing and urge swift action to bring PBMs and their insurer-partners under control.”

Click for NCPA’s comments.

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Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.

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