NCPA Applauds House Committee Approval of PBM Reform Provisions

Full House should swiftly consider bipartisan package, NCPA says

NCPA May 24, 2023

ALEXANDRIA, Va. (May 24, 2023) – In a statement released today, Anne Cassity, senior vice president of government affairs at the National Community Pharmacists Association, says NCPA is pleased the House Energy and Commerce Committee passed the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act (H.R. 3561), which includes several provisions vital to lowering prescription drug costs and bringing transparency to anticompetitive practices of pharmacy benefit managers.

“Patients and community pharmacies have been advocating aggressively for years for reforms and insight into PBM practices,” Cassity said. “This comprehensive package would take significant strides forward in terms of federal oversight, and NCPA is proud to support it. We’re grateful to the committee for its work and hope the full House will soon advance it.”

The PATIENT Act passed the committee in a unanimous vote of 49-0. NCPA-supported provisions within it include:

  • The Drug Price Transparency in Medicaid Act (H.R. 1613). This legislation, which was introduced by Reps. Buddy Carter (R-Ga.) and Vicente Gonzalez (D-Texas), is an NCPA priority. It would prevent the use of spread pricing in Medicaid managed care programs while moving to a fair and transparent pharmacy reimbursement system based on average acquisition costs plus the state’s Medicaid fee for service dispensing fee and require all pharmacies to respond to the Centers for Medicare & Medicaid Services’ National Average Drug Acquisition Costs survey, which would provide more transparency on drug pricing. The Congressional Budget Office estimated this provision would save taxpayers over $1 billion.
  • The PBM Accountability Act (H.R. 2679), from Reps. Annie Kuster (D-N.H.), Buddy Carter (R-Ga.), Anna Eshoo (D-Calif.) and Brett Guthrie (R-Ky.), which would provide transparency to employers by requiring reporting from PBMs on drug spending, including out-of-pocket costs and rebates.
  • The Promoting Transparency and Healthy Competition in Medicare Act (H.R. 3282), from Reps. Diana Harshbarger (R-Tenn.) and Kim Schrier (D-Wash.), which would increase transparency into the negative effects of vertical integration in health care by requiring Medicare Part D plan sponsors to report data on their interactions with their affiliated PBMs and pharmacies.

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Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 19,400 pharmacies that employ nearly 240,000 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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