Leading Consumer Groups Back Transparency Requirements For Pharmacy Benefit Managers In Health Care Reform

Main Category: Pharmacy / Pharmacist
Article Date: 21 Aug 2009 - 23:00 PDT

email to a friend   printer friendly   opinions  

Three top consumer groups are urging Congress to include in health care reform legislation transparency requirements for pharmacy benefit managers (PBMs) participating in any new federally sponsored health plans in a public health care exchange. The Consumer Federation of America (CFA), U.S Public Interest Research Group (PIRG), and the National Legislative Association on Prescription Drug Prices (NLARx) have sent a joint letter to House Speaker Nancy Pelosi (D-CA) supporting the provision, authored by Rep. Anthony Weiner (D-NY) and included in the House Energy and Commerce Committee's America's Affordable Health Choices Act of 2009 (H.R. 3200). In response to the consumer groups' letter, Bruce T. Roberts, RPh, National Community Pharmacists Association (NCPA) executive vice president and CEO issued the following statement:

"The momentum is growing to finally force PBMs to play by the same set of rules as everyone else. For too long these administrators of prescription drug plans have operated in secrecy. That's especially true in the case of payments they command from drug manufacturers in exchange for promoting one product over another. And any discounts PBMs do negotiate are hidden and withheld from health plan sponsors (governments, employers, etc.), patients and pharmacies. Thanks to Congressman Weiner there is legislative language in the health care reform bill to essentially open the PBM books and bring transparency into the process. NCPA strongly supports this provision.

"We are heartened to learn a diverse coalition of consumer-oriented groups also supports the need for creating sunshine in the business practices of PBMs like CVS Caremark, Medco Health Solutions, and Express Scripts. The coalition recognizes you can't have real reform while leaving an entire segment of the health care system to act in an unaccountable fashion."

What follows are two excerpts from the letter to Speaker Pelosi in support of the provision:

Excerpt #1 - "Because of the lack of regulation PBMs engage in fraudulent and deceptive practices, resulting in several enforcement actions by a coalition of state attorneys generals that have secured over $370 million in fines and penalties. At the same time the profits of the three major PBMs has skyrocketed to almost $3 billion annually. No other segment of the healthcare market has a record of such deceptive, egregious and anti-consumer practices. Transparency legislation is necessary to curb these harmful practices."

Excerpt #2 - "Where states and health care plans have secured transparency, they have saved hundreds of millions of dollars in reduced drug costs. Transparency legislation offers a significant opportunity to help 'bend the curve' of escalating drug costs and prevent the deceptive conduct of PBMs."

To view a copy of the entire letter go here.

Source
The National Community Pharmacists Association

• Additional
• References
• Citations