NCPA Supports Reps. Braley and Welch in Their Push for Congressional Oversight Hearings on Unregulated Pharmacy Benefit Manager Industry

Alexandria, VA - June 10, 2010

 

U.S. Representatives Bruce Braley (D-IA) and Peter Welch (D-VT) have sent a letter calling for an oversight hearing of the pharmacy benefit manager (PBM) industry at the full committee or subcommittee level of the House Energy and Commerce committee with the respective chairs Henry Waxman (D-CA), Bart Stupak (D-MI), and Frank Pallone (D-NJ). PBMs have grown into giant administrators of prescription drug plans in the last couple of decades, but the lack of transparency and accountability allow them to make pricing and therapeutic decisions that can conflict with the interests of patients, pharmacists, and plan sponsors. In response, Joseph H. Harmison, PD, NCPA president and an Arlington, Texas pharmacy owner, issued the following statement. 

"Representatives Bruce Braley and Peter Welch should be commended for advocating Congressional oversight hearings of PBMs. In growing from simple prescription drug claim adjudicators to corporate middlemen behemoths, PBMs are essentially playing a game of 'Three Card Monte'. Patients, pharmacists and plan sponsors are supposed to have 'confidence' in PBMs, but are being 'persuaded' into accepting a prescription drug delivery system geared towards maximizing PBMs profits at their expense. This occurs mostly because PBMs are largely unregulated, forcing corrective actions to be taken either at the state legislative level or through the court system; such actions have resulted in approximately $370 million in legal settlements with PBMs. Those efforts have produced some improvements, but the U.S. Congress has the power to bring about real change. 

"The hearing Braley and Welch call for could create momentum for passing current legislative solutions to problematic PBM business practices or even spark the consideration of additional legislative solutions. 

"A hearing will help shine a spotlight on several troubling questions that need answers if patients, pharmacies and plan sponsors are going to be treated fairly. Is it fair for PBMs to contract with independent community pharmacies for access to patients, while steering some of those patients to mail order and retail pharmacies they own at higher cost to plan sponsors? Is it fair for PBMs to secretly receive rebates from drug manufacturers for favoring certain prescription drugs over others, and then pocket commissions as high as 50% before passing the rest on to patients and plan sponsors? Is it fair for PBMs to force independent community pharmacies into 'take-it-or-leave-it' contracts for access to patients that have onerous terms? The list of questions is seemingly endless, but a federal hearing is the right venue for some substantive answers to be found."

The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.

Ask Your Family Pharmacist TM