PBM Accountability Project Statement on Passage of Critical PBM Reforms

Congress passed and President Trump signed a bipartisan spending bill today with several key provisions to hold pharmacy benefit managers (PBMs) accountable. Mark Blum, managing director of the PBM Accountability Project, issued the following statement:

“Today’s passage of PBM reform legislation marks an important milestone in our fight to make the prescription drug system more transparent, accountable and affordable for hardworking Americans. The PBM reforms in the spending package realign PBM incentives away from profiting off higher list prices and toward flat, transparent fees, helping patients see more of the savings at the pharmacy counter and improving access to needed medicines. By tracking how PBMs pay pharmacies, the bill strengthens independent and community pharmacists while giving employers and other plan sponsors clearer visibility into how their healthcare dollars are used.

“But our work is far from finished. What’s more, lawmakers on both sides of the aisle have made clear they understand that passing these crucial reforms is the first step in addressing an unnecessarily opaque and complex system that is rigged against patients and their ability to afford life-saving medicines.

“As we know, PBMs and their affiliated entities will continue to play games to siphon money away from patients into their own pockets. The next challenge is confronting the growing vertical integration across the healthcare industry where the nation’s largest health insurers, PBMs, GPOs and pharmacy chains are increasingly merging into consolidated behemoths that dominate the marketplace.

“This consolidation has given a handful of giant corporations unprecedented control over which medicines patients can access, how much they pay and which pharmacies survive. The result is fewer choices, higher out-of-pocket costs and greater barriers to care for millions of Americans.

“We need to continue shining a light on these integrated corporate structures and advance policies that restore fair competition, protect independent pharmacies, and ensure that savings flow to patients and plan sponsors – not to vertically integrated conglomerates. True accountability in drug pricing means addressing every link in the chain. The PBM Accountability Project is committed to continue working with policymakers to ensure this next stage of reform builds on the progress we’ve made. Patients deserve a healthcare system that works for them, not one controlled by a few corporate interests.”