The Department of Government Efficiency should focus on the role of the big three pharmacy benefit managers in siphoning off profits at the expense of taxpayers, patients, and local, independent pharmacies, NCPA said in a late-December letter to the non-governmental entity charged with creating efficiencies and tax savings in government programs as part of the coming Trump administration.
NCPA CEO Douglas Hoey noted that federal and state governments pay billions of dollars a year to the big three PBMs to administer government programs like Medicare Part D, Tricare, and federal employee health benefits plans.
"The PBMs essentially hold states and the federal government hostage by threatening to jack up premiums if they are required to behave fairly or openly. Indeed, they've spent tens of millions of dollars fighting against any legislation that would require more transparency, let alone changes to their business model. And of course, they would because they are perhaps the only businesses in the world with the power to set prices for their smaller competitors and tell their competitors' customers where to shop," said Hoey.
Hoey also suggested that DOGE work with the Centers for Medicare & Medicaid Services to eliminate or significantly reform the Medicare Drug Price Negotiation Program of the Inflation Reduction Act. He expressed NCPA's concern that pharmacies will have to float the MDPN program to the tune of roughly $27,000 per independent pharmacy per month, that pharmacies won't receive fair compensation from PBMs, and that manufacturer refund payments to pharmacies will be delayed.
For the full press release, click here. To read the letter, click here.
