Action is essential component of PBM reform.
WASHINGTON – The National Association of Chain Drug Stores (NACDS) is hailing the U.S. House of Representatives Committee on Energy and Commerce for their bipartisan commitment to crack down on tactics by which “pharmaceutical benefit manipulator” middlemen maximize profits at the expense of patients, pharmacies and others. On Wednesday, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act (H.R. 3561) unanimously cleared the Committee on a 49-0 vote.
Of note, the bill includes provisions that prohibit “spread pricing” in Medicaid and establish a “pass-through payment” model. They create in Medicaid managed care a “rate floor” requirement similar to that of Medicaid fee-for-service that focuses on cost-based pharmacy reimbursement and dispensing fees.
NACDS President and CEO Steven Anderson said: “We applaud House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Ranking Member Frank Pallone (D-NJ) for their leadership and for their continued work to put patients before PBM profits. The unanimous passage of the PATIENT Act out of the Committee further demonstrates the strong bipartisan commitment that exists to confront the harmful PBM tactics that threaten patients and the pharmacies serving them.”
Overall, NACDS is advocating for comprehensive PBM reform across all payer segments, consistent with NACDS’ Principles of PBM Reform. Direct and indirect remuneration fee (DIR fee) reform remains an important aspect of PBM reform. NACDS’ Principles of PBM reform include: stopping explosive retroactive fees; stopping below-cost reimbursement; stopping the gaming of performance measures; stopping “specialty definitions” from steering patients from their pharmacy; stopping mandatory mail-order; stopping limited networks; stopping overwhelming audits; and stopping the undercutting of “PBM” reform laws.
See the NACDS statement released Tuesday applauding the U.S. House of Representatives Committee on Energy and Commerce for the inclusion of H.R. 1613 into the PATIENT Act.
An NACDS explainer video highlights the importance of comprehensive PBM reform for patients and pharmacies.
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