No, they’re not, agreed bipartisan Members of Congress and witnesses agreed during a House hearing yesterday.
What happened: The House Committee on Oversight and Accountability held a May 23 hearing, The Role of Pharmacy Benefit Managers in Prescription Drug Markets Part I: Self-Interest or Health Care? Witnesses included an oncology doctor, an independent pharmacist, and a PBM CEO (whose testimony may surprise you).
Catch up: What are PBMs, anyway?
What Republicans are saying: “List prices for prescription drugs have gone through the roof even though net prices have declined,” said Committee Chair James Comer (R-KY). Who’s benefitting? “Look no further than PBMs.”
What Democrats are saying: “If the U.S. healthcare system worked as intended, PBMs should be negotiating lower drug prices on behalf of insurance companies who would then pass the savings on to their patients, but that’s not what’s happening,” said Ranking Member Jamie Raskin (D-MD). “Some PBM practices appear to be increasing the cost of medicine, actively preventing patients from accessing the drugs that their doctors have determined are appropriate for them, playing outrageous hide-and-go-seek games with people’s medicine, and hurting independent and community pharmacies.”
What one PBM said: “Traditional PBMs tell their clients they use their size and scale to get a better deal that smaller companies cannot compete with,” said Greg Baker, CEO of AffirmedRx, a “transparent” PBM. “But they do not always use that purchasing power to help their clients.” (He said his company publishes prices and rebates.)
What else was discussed: drug pricing and the Inflation Reduction Act (IRA), PBMs operating outside of the U.S., spread pricing, and the problems with step therapy—read the full recap at Bio.News.
The context: The House and Senate are considering PBM transparency legislation and have held numerous hearings in recent weeks echoing many of these concerns—catch up at Bio.News.
Watch: How PBMs Leave Patients Behind
