WASHINGTON — Panels in both the House and Senate have now passed restrictions to drug middlemen business practices, increasing the chances of those measures being included in future government spending bills.
The bipartisan reforms to pharmacy benefit managers were among 21 bills that the House Energy & Commerce health subcommittee passed today. The policies are not identical, but at least three PBM reforms have been passed by panels in both chambers:
- One that would replace PBM fees that are tied to a percentage of drug prices with flat fees
- Another that would require Medicare to create standard performance measures on which PBMs base pharmacy payments
- A third that would require PBMs to report a host of information, including drug costs, savings, beneficiary out-of-pocket costs, payments to pharmacies, and the amount of business directed to PBM-owned pharmacies
The Energy & Commerce subcommittee also passed other bills that mirror legislation that Senate Finance also has passed. That includes legislation to ensure seniors pay no more for drugs than insurers, and a measure that lets insurers add less-expensive biosimilars to formularies mid-year.