Photo credit: thehill.com

Lawmakers Urge FTC to Release Interim Report on Pharmacy Benefit Managers

A coalition of bipartisan lawmakers is urging the Federal Trade Commission (FTC) to promptly release an interim staff report concerning pharmacy benefit managers (PBMs). This appeal comes ahead of an open commission meeting scheduled for January 14, during which the FTC will deliberate on a second interim report relating to PBMs.

Among the signatories are Senators Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.), along with Representatives Jake Auchincloss (D-Mass.) and Diana Harshbarger (R-Tenn.). They emphasized the role of PBMs, stating that these entities were initially established to manage prescription drug benefits for health plans, negotiating with drug manufacturers and establishing pharmacy networks.

However, over time, these intermediaries have transformed into significant, vertically-integrated entities that dominate every aspect of the drug coverage and delivery system, encompassing pharmacies and payers as well.

The FTC’s investigation into PBMs commenced in 2022. In 2023, the agency published its first interim staff report, which revealed that leading PBMs leverage their substantial market power to generate profits at the expense of patients and independent pharmacies.

FTC Chair Lina Khan noted that the findings indicated how PBMs could impose hardships on independent pharmacies, which are particularly vital for many Americans, including residents of rural areas. She also pointed out that these managers contribute to increased drug costs for patients, including those requiring essential treatments like cancer medication.

Previously proposed reforms targeting PBMs were excluded from recent government funding legislation, despite calls for measures such as banning PBM compensation linked to Medicare drug prices. Additionally, there were suggestions for mandating that PBMs fully pass 100 percent of drug rebates and discounts to employers or health plans.

The forthcoming interim report is anticipated to include insights from the FTC’s ongoing examination of PBM contracting practices.

The lawmakers, who wrote to the FTC, had introduced a bipartisan bill last month aimed at prohibiting the simultaneous ownership of PBMs and pharmacies, describing this as a significant conflict of interest. They drew from the FTC’s previous report to support their legislative efforts.

They expressed hope that the second interim report would further illuminate the challenges posed by PBMs, which they believe will be crucial for shaping legislative priorities in Congress.

In their letter, they stated, “We expect a second interim report will shine further light on the industry that will be invaluable to legislators as the policy priorities of the 119th Congress take shape. Accordingly, we urge the FTC to issue its second interim staff report swiftly and continue investigating the serious effects of the PBM industry on patients, taxpayers, and independent pharmacies.”

The FTC’s open commission meeting is set to take place virtually on January 14 at 11 a.m. EST, providing an opportunity for public commentary.

Source
thehill.com