The House Ways and Means committee on Wednesday marked up legislation that would require pharmacy benefit managers to de-link their compensation from the price of a drug, adding to the bipartisan momentum around reforming the middlemen.
The bill would require PBMs that contract with Medicare to “de-link” PBM compensation from the price of medications and instead charge a flat fee for their services. The measure has drawn pushback from the Pharmaceutical Care Management Association, which lobbies on behalf of PBMs.
The bill is similar to other measures moving through Congress that seek to rein in PBM practices, including legislation introduced in the Senate last summer.
PCMA has argued that delinking provisions would take away necessary negotiating tactics that PBMs use to get lower prices from manufacturers that they pass on to patients.
“Policies that eliminate performance-based payment move the PBM market back towards a fee for service system, increasing costs across the healthcare system,” Joe Grogan, visiting senior fellow at the USC Schaeffer Center and former president Donald Trump’s director of domestic policy, wrote in an op-ed cited by PCMA.
PBM reform has notably garnered bipartisan support over the past year, though a handful of lawmakers have voiced holdups.
Rep. John Larson (D-CT) on Wednesday spoke out against the PBM provision at the markup, raising concerns that the bill will ultimately lead to higher costs for Medicare beneficiaries.
“That’s my main concern,” he said. “Considering, if you will, that raising the price on the backs of our seniors, especially at a time when Congress has not acted on enhancing social security in more than 50 years.”