PBM Accountability Project Statement on State of the Union Address

President Trump touched briefly on affordability of healthcare in his record 1 hour and 40-minute State of the Union address Tuesday evening. Mark Blum, managing director of the PBM Accountability Project, issued the following statement: 

“Affordability of healthcare is a top concern for America’s working families – particularly when it comes to the cost of prescription drugs. President Trump has rightly focused attention on the exploitative business practices of insurance corporations and the PBM middlemen they have acquired and merged into vertically integrated health insurance conglomerates. 

“The Medicare Part D PBM reform that President Trump signed into law earlier this month is an important step toward making prescriptions more affordable for hardworking Americans. Those reforms prohibited an entireclass of cost-increasing PBM drug pricing schemes that serve no purpose but to increase PBM profits at the expense of senior Americans. But as quickly as Congress begins to debate prohibition of one class of exploitative PBM pricing schemes, PBMs and their insurance corporation owners create multiple new schemes that are not yet prohibited but have the same effect…and the cycle goes on and on. The creation of offshore Group Purchasing Organizations (GPOs) by the largest three PBMs in America (each merged with one of the three largest insurance corporations) is the latest example. GPOs create a new vertical layer of insurance conglomerate-owned drug supply chain – often offshore and out of sight of regulators – designed to skim rebates and extract profit at the expense of higher drug prices for working Americans and retirees. 

“When President Trump asks Congress to enact his ‘Most Favored Nation’ pricing policy, as he did Tuesday evening, we ask our policymakers to keep in mind that manufacturer pricing regulations will not lower out-of-pocket costs for Americans as long a PBMs retain control over what we pay for medicines and whether we have access to them. We call on the Members of Congress who listened to the President’s address Tuesday night to keep their eyes on the three prizes of meaningful prescription drug reform: guaranteeing patient access to the medicines their physicians prescribe, lowering patients’ out-of-pocket costs and reducing health insurance premiums. Don’t let the noise distract you.”