Senate Finance Chair Ron Wyden. Photo: Drew Angerer/Getty Images
The drumbeat for PBM reforms is intensifying, highlighted by a scathing Federal Trade Commission report on the industry's business practices and a coming House Oversight hearing with top CEOs.
Why it matters: While statements and denunciations certainly don't automatically translate into legislative action, the more momentum builds, the more pressure there will be to include PBM measures in a lame-duck health care package as a way of addressing rising drug prices.
What they're saying: Senate Finance Chair Ron Wyden pointed to the FTC report's findings in stressing his commitment to get legislation over the finish line.
- "The Finance Committee overwhelmingly passed legislation to hold PBMs accountable, and I am going to the mat to deliver that bill to the president's desk this year," he said.
- That legislation includes "delinking" Medicare PBM compensation so that it's not tied to the price of a drug, as well as transparency measures and other provisions.
Driving the news: PBMs will also be in the spotlight on July 23, as we reported yesterday, when the House Oversight Committee holds a hearing with executives from the three largest companies: CVS Caremark, Express Scripts and OptumRx.
- A verbal misstep by one of the executives could provide more fodder for critics.
- Even short of that, it will likely be a display of bipartisan concern with PBM business practices, such as steering business away from smaller independent pharmacies or requiring unfair contract terms, as the FTC report detailed.
Yes, but: There's still a long way to go just winnowing the array of competing proposals.
- And there are still questions around some of the policies, such as delinking, which PBMs are stoking opposition to.
