In the News

Politico Pro: House passes PBM transparency bills

Washington, October 28, 2019
POLITICO PRO, SARAH KARLIN-SMITH

The House today unanimously passed a bill that would require more public disclosure of the discounts drug companies give to pharmacy benefit managers.

Rep. Abigail Spanberger's bill, H.R. 2115 (116), approved 403-0, would require PBMs to report to HHS their aggregate rebates, discounts and other price concessions received on drugs from manufacturers. The department would then be required to publicly post aggregate rebate data and generic dispensing rates online. Information on rebates would be posted on the drug class level, as long as there are at least three drugs in the class and the information does not display confidential information for rebates received for an individual drug.

The bill would also make public some information available on the compensation PBMs receive from pharmacies.

The House later passed by voice vote a measure by Rep. Buddy Carter, H.R. 1781 (116), which would give MedPac and MACPAC access to drug pricing and rebate data to help Congress better understand how the drug market is operating.

The goal of both bills is to obtain more data to try and address concerns that PBMs may be contributing to higher drug prices by favoring high-list price drugs with large rebates. PBMs are accused of pocketing the sum of these rebates as profits and then basing patients share of a drug off the list price. The PBMs argue they use rebates to lower the cost of patients premiums.

Spanberger's bill would additionally require Medicare Part D plans to provide patients with information that is integrated into their health care providers' electronic prescribing system or electronic health records about their cost-sharing responsibility for a drug as well as their cost-sharing for clinically appropriate alternatives on their plan's formulary. Plans will have to provide these out-of-pocket costs for the drugs at a variety of nearby pharmacies, so patients can determine the be option.