PBM Practices: It’s Time for Policymakers to Act
Dear Colleagues,
Last week, the Federal Trade Commission (FTC) released its highly anticipated interim report that underscores the adverse impact pharmacy benefit managers (PBMs) have on the accessibility and affordability of prescription drugs.
The report, part of an ongoing investigation that ASHP requested in 2022, describes how dominant PBMs increase the cost of drugs and impose unfair, arbitrary, and harmful contractual terms that negatively impact our members and their patients every day.
PBMs dictate which drugs are available to patients and how much they cost. By favoring their own affiliated pharmacies and negotiating rebates with manufacturers, PBMs steer patients away from lower-cost generics and biosimilars and drive up prescription drug costs.
Policymakers must step up now to end abusive PBM practices that undermine patient access to safe and effective medications.
PBM reform remains one of ASHP’s long-standing advocacy issues, and we strongly support recent federal legislation reining in PBMs.
At the state level, ASHP continues to encourage the use of our model legislation and related resources to curb white bagging, a harmful practice in which payers and PBMs favor their own affiliated pharmacies. The FTC report makes it clear that white bagging increases drug costs.
ASHP has also long advocated for the adoption of lower-cost generics and biosimilars, a cost-saving and clinically appropriate approach to care that is undermined by PBM rebates.
The Senate recently passed ASHP-supported legislation prohibiting drug manufacturers from using a complex web of patents to prevent competition from generic and biosimilar products. This is a strong advocacy win for patients, and we fully support this legislation as it advances in the House of Representatives.
ASHP also supports the Biosimilar Red Tape Elimination Act, which would eliminate the need for clinically unnecessary switching studies that delay the use of biosimilars.
ASHP’s government relations team is finalizing new model state legislation that will empower pharmacists to substitute lower-cost biosimilar products for therapeutically equivalent branded biologic medications, making medications more affordable for patients.
While we have made progress in highlighting the need for serious PBM reforms, we have much work to do. ASHP will continue to urge federal and state policymakers to enact reforms supporting pharmacists and their efforts to help ensure safe, effective, and more affordable medications for the patients they serve.
Thank you for all you do for your patients and our profession.
Sincerely,
Paul
Posted on July 19, 2024