House Oversight Committee to take up transparency measures for PBMs
The House Committee on Oversight and Accountability will take up the role of pharmacy benefit managers on Tuesday, May 23.
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The full House Committee on Oversight and Accountability is scheduled to take up the role of pharmacy benefit managers on Tuesday, May 23, at 10 a.m., after a subcommittee advanced a proposal Wednesday for new transparency rules.
The House subcommittee examined the role of PBMs in increasing healthcare costs and in the drug supply chain and determined more transparency is needed.
"Pharmacy Benefit Managers' anticompetitive tactics are driving up healthcare costs for Americans and harming patient care. Greater transparency in the PBM industry is vital to determine the impact that their tactics are having on patients, the pharmaceutical market, and healthcare programs administered by the federal government," said James Comer, R-Kentucky, chairman of the House Oversight Committee, prior to the hearing, "The Role of Pharmacy Benefit Managers in Prescription Drug Markets Part I: Self-Interest or Health Care?"
WHY THIS MATTERS
PBMs have long come under scrutiny for being the middlemen for drug manufacturers and in issuing rebates.
In March, Comer requested that the largest PBMs – CVS Caremark, Express Scripts and OptumRx – provide documents, communications and information related to their practices. These three are estimated to control 80% of the market.
The Federal Trade Commission is also seeking information from two privately held companies that negotiate drug rebates on behalf of pharmacy benefit managers, Zinc Health Services and Ascent Health Services, according to Reuters.
THE LARGER TREND
On March 1, Comer launched an investigation into PBMs' role in rising healthcare costs. He requested senior officials at the Office of Personnel Management, Centers for Medicare and Medicaid Services, and the Defense Health Agency to provide documents and communications to determine the extent PBMs' "tactics" impact healthcare programs administered by the federal government.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
