Illustration: Tiffany Herring/Axios
PhRMA will be "laser-focused" on getting PBM changes passed in the lame duck session, the group's CEO, Steve Ubl, told reporters this week.
Why it matters: There is bipartisan support in Congress for overhauling PBMs, but lawmakers so far have struggled to reconcile competing proposals and get something passed. A push from outside groups can at least boost the effort.
What they're saying: "This is one of the rare areas of bipartisan agreement in health policy, and we're going to be laser-focused on getting it over the finish line with a lot of other stakeholders," Ubl said at a press briefing.
- He called for action "this year," and said that a string of bipartisan committee votes, as well as the FTC's lawsuit accusing PBMs of illegally inflating the price of insulin, had helped "provide real momentum."
- Possible changes include "delinking" PBM compensation from the price of a drug; new transparency measures; and basing patient cost on the net price instead of list price for some drugs.
The other side: PBMs counter that they are the only ones in the supply chain trying to lower drug costs, and that drug companies, who set the initial list prices of drugs, are simply looking to tie PBMs' hands through this legislation.
Between the lines: On another front, PhRMA is decrying the Inflation Reduction Act's impact on innovation.
- Their messaging at Tuesday's briefing focused not on full repeal of the law but on changes like giving small molecule drugs longer exemptions before they can be subject to negotiations. That would provide the same 13-year period that biologics get.
- Ubl recalled the Affordable Care Act, saying that after an initial period in which lawmakers did not want to touch their "signature accomplishment," there were "pretty significant changes to the ACA over time."
- "I think we're getting to that window as well with regard to the IRA," he added.
Yes, but: The bill to delay negotiation for small molecule drugs does have two Democratic cosponsors, but leading Democrats still are not interested in easing back on the IRA's negotiation provisions.
