Illustration: Aïda Amer/Axios
The Senate Finance Committee on Wednesday approved a measure aimed at reforming PBM practices on a broad bipartisan vote of 26-1.
Why it matters: The move adds to the flurry of activity in both chambers on PBMs, highlighting the interest in both parties in getting changes across the finish line.
Driving the news: The measure includes a range of provisions that Chairman Ron Wyden said would crack down on health care spending being "frittered away on outdated middlemen practices."
- It would delink PBM compensation from the price of a drug, aiming to remove an incentive for PBMs to prefer drugs with high list prices.
- It would ban spread pricing, targeting the practice of a PBM paying a pharmacy less than it charged the health plan for a drug.
- It includes new transparency and reporting requirements, a common theme across PBM bills.
Between the lines: The friendly markup highlighted that there is a lot of bipartisan agreement on the need to change PBM practices.
- "I've never seen so much harmony in a committee," remarked Sen. Ben Cardin.
- Only Sen. Ron Johnson voted no, saying the measure added "barnacles" of government interference rather than removing them.
Yes, but: There are a lot of cooks in the kitchen, with the Senate HELP and Commerce Committees, as well as the House, all working on PBM bills that will need to be combined in some way.
- Sen. Sheldon Whitehouse warned that Congress should not get distracted from the larger issue of targeting drug manufacturers for their prices and become a "tool of the pharmaceutical industry" by only targeting PBMs.
- “Delinking legislation is being driven by Big Pharma to limit pharmacy benefit companies’ ability to fight to lower drug costs for patients while increasing their profits," PCMA, the PBM trade group, said in a statement.
What's next: Wyden and ranking member Mike Crapo emphasized that additional proposals on PBMs could be added over the August recess.
- One possibility is a measure backed by Sen. James Lankford to require Medicare Part D to cover cheaper generics and biosimilars on a more favorable tier with lower cost-sharing.
