Harshbarger Introduces Bill To Lower Prescription Drug Costs
A bill aimed at reducing prescription costs has been introduced in Congress. Tennessee’s First Congressional District Representative Diana Harshbarger, a pharmacist by trade, co-sponsored the legislation with Rep. Jake Auchincloss, a democrat from Massachusettes and James Comer,a fellow republican from Kentucky. It is called the Pharmacists Fight Back Act and is designed to tackle the practices of Pharmacy Benefit Managers that drive up prescription costs.
Pharmacy Benefit Managers, or PBMS, are the middlemen between your doctor and your pharmacist, as they are the ones that manage prescription drug benefits for health plans, employers, and government programs. They are the ones that come up formulary drug lists, process claims and manage pharmacy networks. While intended to lower drug costs, according to lawmakers, due to a lack of transparency and oversight, PBM’s have actually increased cost.
Harshbarger says this bill implements a transparent pharmacy reimbursement model using market-based pricing benchmarked to the National Average Drug Acquisition Cost, which is the average price retail pharmacies pay wholesalers for prescription drugs. It also removes the ability of PBMs to limit the network of pharmacies patients may choose to use and protects community pharmacists by prohibiting PBMs from steering patients to PBM-affiliated pharmacies. It enforces stricter penalties and more stringent oversight of PBMs working with federal health plans.
Rep. Harshbarger says “Patients and community pharmacists are being hurt by a system that PBMs have distorted for years which drives up out-of-pocket costs and forces local pharmacies out of business”.
Rep. James Comer, who is the chairman of the House Committee on Oversight and Government Reform, says “Rarely does a day go by without hearing from my constituents in Kentucky who are struggling under the weight of soaring prescription drug costs. The questions I hear time and again are: Why is this happening? And who is benefiting? My response is the same each time, it’s the PBMs—the pharmacy benefit managers—who sit in the middle of nearly every prescription transaction. PBMs have abused their position as middlemen to line their own pockets by retaining rebates and fees, undermine our community pharmacists and pass along costs to patients at the pharmacy counter. Congress has a responsibility to act and that’s why I am proud to support the bipartisan Pharmacists Fight Back Act. This legislation takes meaningful steps to protect patients and our community pharmacists, ensuring they can access and provide affordable, life-saving medications to Americans without PBM interference. I look forward to working with Rep. Auchincloss, Rep. Harshbarger, and our local pharmacists to get this legislation to the President’s desk.”
Members of the healthcare industry hailed the bill as well. Madelaine Feldman, MD, FACR; Rheumatologist; Vice President, Advocacy & Government Affairs; Coalition of State Rheumatology Organizations said in a statement: “While PBMs claim to create “savings” through manufacturer rebates and discounts, those “savings” rarely trickle down to the patient. The Pharmacists Fight Back Act will not only reduce beneficiaries out-of-pocket costs by passing rebates directly back to the patient, but will also ban plans from mandating higher priced brand name drugs over lower priced generics on formularies, foster transparency and promote fairness in the system by prohibiting PBMs from steering patients to their own pharmacies; not to mention the hefty fine PBMs will pay for each violation.”