With the recent agreement to fund the government through the end of the fiscal year and the decision not to include provisions targeting pharmacy benefit companies, there is an opportunity to think again before misguided legislation is advanced that would do nothing to lower prescription drug costs for patients. PCMA and the pharmacy benefit companies we represent want to use this time to continue engaging policymakers to make sure that policies that are advanced will address their concerns, while not increasing costs for patients or limiting choices for employers and other plan sponsors.
PBMs serve as a significant check against big pharmaceutical companies’ otherwise limitless pricing power. Legislation that restricts the work done by pharmacy benefit companies to lower drug costs would undermine free market negotiations and only serve to give drug companies more power to keep costs high.
Over the course of this year’s congressional session, and into the latest budget agreement, the rancor on PBMs reached a fever pitch. The White House held a so-called “listening session” that omitted a representative from our industry or any acknowledgment of the role of PBMs as negotiators for lower drug costs, nor mention of the competitiveness of the PBM market – which gives employers choice and flexibility in managing prescription drug costs for their employees.
It’s past time that the vocal animus from PBM detractors is countered with truth and clarity. The core mission of America’s pharmacy benefit companies is to ensure that every patient has affordable access to the drugs they need. Our industry principles of affordability, transparency, and accessibility drive our members to negotiate lower prescription drug costs and increase access to affordable medicine in a more competitive marketplace. These principles are the reason that nearly all employers in America voluntarily choose to contract with a PBM. It should never be overlooked that PBMs save patients more than $1,000 each year, working to reduce prescription drug costs for patients and employers.
Many of the pharma-backed policies on the table during the recent government funding negotiation not only fail to recognize that rebates are uncorrelated to higher drug prices, but would fundamentally tip the scales in the marketplace further into the hands of drug companies. The impact of one proposal was estimated to increase health care premiums by nearly $40 billion and reward drug companies with $32 billion in increased profits.
To be clear, we know that more can be done, and we share the goal of the Administration and Congress of lowering prescription drug costs. The PBM market is already responding to new requests for more data and reporting, and we have engaged policymakers constructively on those issues to ensure policymakers, PBM clients, patients, and their prescribers have the information they need. We are putting forward policy ideas to enable pharmacies to do more to support patients and to support the future of their businesses. We have supported myriad proposals to address anti-competitive manufacturer practices that are the root cause of high drug prices and foster greater competition in the marketplace from more affordable options, like generics and biosimilars.
Lawmakers now have a tremendous opportunity to reset the prescription drug debate and bring the focus of the conversation back to market-based solutions that will effectively lower prices for patients, taxpayers, and employers.
We urge Congress to take the time to get it right on drug prices and stand ready to continue doing our part to engage, put forward, and support real reform that will help American patients and businesses.
JC Scott is the president and CEO of the Pharmaceutical Care Management Association (PCMA).
