How you can take action on PBMs

The Senate Finance Committee advanced critically important PBM transparency legislation—here’s what happened and how you can take action. Plus, BIO joined 45+ organizations in condemning the Biden administration’s recent decision on international data flows. (703 words, 3 minutes, 30 seconds)

PBM transparency legislation advances in Senate

The Senate Finance Committee advanced legislation that would shine a light on the “shadowy” practices of middlemen who drive up drug prices—keep reading to learn more and how you can take action.

What happened: The Senate Finance Committee yesterdayadvanced the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act—which includes the Modernizing and Ensuring PBM Accountability (MEPA) Act, as well as other provisions on mental health, expiring Medicare and Medicaid policies, and Medicare physician payment.

What are PBMs? PBMs choose which drugs receive insurance coverage, charging drug makers rebates and fees for covering them. PBMs profit from keeping drug prices high—and they’re often integrated with pharmacy chains and insurers, with three PBMs controlling 80% of the market.

What it does: The bill would “rein in the shadowy tactics by pharmacy benefit managers that hurt community pharmacies and drive up prescription drug costs for seniors and taxpayers,” said co-sponsor Senate Finance Chair Ron Wyden (D-OR).

Why it matters: “In advancing the Modernizing and Ensuring PBM Accountability Act, we demonstrated the bipartisan conviction and momentum needed to move good policy from concept into law,” added co-sponsor Ranking Member Mike Crapo (R-ID).

What’s next: Wyden and Crapo agreed to work on incorporating additional provisions before full Senate action. (See the Beltway Report below for more.)

Watch a recap:

 
BIO launched a PBM action campaign—click here to contact your lawmaker and urge them to hold PBMs accountable. 

BIO condemns U.S. decision to back off demands for free-flowing data

The Biden administration is stepping back from protecting international data flows, a decision BIO and the U.S. Chamber of Commerce condemn in a letter to administration officials and congressional leaders.

ICYMI: U.S. Trade Representative Katherine Tai announced Oct. 25 she would drop longstanding U.S. demands that World Trade Organization e-commerce rules permit free flow of data. The sudden reversal is intended to facilitate Administration plans to regulate big tech, Reuters reports.

Why it matters to business: Free-flowing global data facilitates the participation of U.S. businesses in international trade and helps startups scale up internationally. Biotech research benefits from robust, reliable, and secure access to a pool of scientifically relevant data from around the world, says BIO. Restrictions on data transfers can compromise global research collaborations and scientific progress.

Why it matters to democracy: Critics say governments can use localized data systems to censor information and conduct surveillance. Sen. Ron Wyden (D-OR) calls the administration’s decision “a win for China,” adding U.S. regulation of big tech is possible without allowing localized data rules.

When other countries “restrict cross-border access to knowledge and information, they undermine human rights, freedom of expression, scientific progress, and the ability to solve shared health, climate, and economic challenges,” says the letter, signed by 45 organizations.

BIO’s view: “The life sciences sector stands ready to deliver breakthrough innovations globally; however, the biotech community requires access to global data sets and the ability to collaborate with partners globally to advance scientific research and deliver new cures, agricultural, and environmental solutions,” says Justin Pine, BIO’s Senior Director of International Affairs.

President Biden’s Thursday: Heading to Rockford, Illinois, where he’ll speak about the United Auto Workers agreement and his commitment to bringing good-paying union jobs to Americans. He’ll then attend a campaign event in Chicago.

What’s Happening on Capitol Hill: Yesterday’s Senate Finance Committee markup of the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act covered a number of other priority issues. Senators raised issues including coverage of multi-cancer early detection screening, safety net hospital uncompensated care, Medicaid coverage of Medication Assisted Treatment (MAT), and Medicaid coverage of nutritious food and other services to address social determinants of health, among many other topics.

Chairman Wyden and Ranking Member Crapo committed to continue to work on policies to enhance Medicare beneficiary access to biosimilars, and to increase Medicare clinician payments for Advanced Alternative Payment Model (APM) participation.