Auchincloss Tackles Drug "Middlemen"

This week,  Franklin's Congressman Jake Auchincloss (D, MA-04) and Diana Harshbarger (R, TN-01) introduced the Pharmacists Fight Back Act to tackle what they called "the manipulative practices of Pharmacy Benefit Managers (PBMs) – the middlemen of drug pricing."  According to a statement from Auchincloss, PBMs are directly responsible for driving up drug costs, gouging community pharmacists, and limiting patient choice in federal healthcare plans. This bipartisan legislation is currently the most comprehensive PBM reform ever introduced at the federal level.

Patients, community pharmacies, and taxpayers have been forced to shoulder the burden of rising drug prices at the hands of PBMs. The lack of PBM accountability has inflated drug costs for seniors at the pharmacy counter, by mandating patients receive expensive brand name drugs when cheaper, generic drugs were prescribed and readily available.

The Pharmacists Fight Back Act reins in large PBMs responsible for hundreds of millions of dollars in overcharges via spread pricing in Medicaid-managed care plans. The bill implements a transparent pharmacy reimbursement model using market-based pricing benchmarked to the national average drug acquisition cost (NADAC). It also removes the ability of PBMs to restrict patient choice via network exclusions, and protects community pharmacists by prohibiting PBMs from steering patients to PBM-affiliated pharmacies.

"The corporate greed of PBMs and their health-insurance overlords has taken money directly out of the pockets of seniors, taxpayers, and pharmacists by inflating the price of medications for their own benefit. This bill protects community pharmacists and patients from price-gouging in federal healthcare programs,” said Rep. Auchincloss.

“As a pharmacist, I know first-hand how pharmacy benefit managers maneuver in the shadows to put the financial screws to independent community pharmacies, and often raise drug costs for patients by steering prescription drug coverage to whatever best pads their bottom line,” said Rep. Harshbarger. “A recent Federal Trade Commission interim report confirms the many ways PBM middlemen self-deal, distort competition and essentially print their own money. I’m proud to help introduce the Pharmacists Fight Back Act, which will put in place much-needed reforms to stop the gouging of independent pharmacies, make life-saving drugs more affordable for patients, and implement solutions that will yield savings to taxpayers.”

“APCI could not be more grateful to Representatives Auchincloss and Harshbarger for their leadership in taking on the unfair practices of big PBMs. The need for comprehensive PBM reform has never been clearer following landmark reporting by the Wall Street Journal and New York Times as well as a scathing FTC report exposing PBM practices that drive up costs and harm pharmacies, patients, and payers,” said Tim Hamrick, CEO, American Pharmacy Cooperative, Inc. “This legislation offers a blueprint for bringing PBM abuses to a screeching halt in federal healthcare plans. This is the bill that pharmacists and patients have been hoping to see.”

“The Pharmacists Fight Back Act is the first and only bill to directly address PBM practices that have left hundreds of communities without pharmacies; diminished or even eliminated access to care for thousands of patients; and artificially inflated health plan premiums and drug costs at the pharmacy counter. This legislation is vital to ensuring patients can maintain access to the pharmacy of their choice, but also - critically - ensuring pharmacies remain viable and open for patient care,” said Monique Whitney, Executive Director, Pharmacists United for Truth and Transparency. “We are grateful to Representatives Auchincloss and Harshbarger for championing legislation that deals directly with the issues that have plagued pharmacies for years, and provides fair, workable solutions.”

“Representative Auchincloss’ and Representative Harshbarger’s bipartisan Pharmacists Fight Back Act is an aggressive effort to put an end to unfair practices of large spread-based PBMs, which raise drug costs for patients and taxpayers in federal healthcare programs. Across pharmacy counters, kitchen tables, board rooms, and community centers, I have witnessed first-hand too many seniors, working families, and Medicare patients suffering under the profiteering and medication rationing festering under big PBMs’ insurance gimmicks and gamesmanship,” said Greg Baker, Pharmacist, CEO of AffirmedRx, a transparent PBM and a founding member of Transparency-Rx, a diverse coalition dedicated to lower drug pricing. “This bill addresses that crisis head on, laying the groundwork for a more transparent approach so drug prices can’t be exploited for profit—curtailing many of the conflicts of interest that pad big PBMs’ profits. If passed, the law would help re-imagine a better, more open American healthcare system, advancing our nation and Medicare program for the 21stCentury.”

“On behalf of the Kentucky Pharmacists Association, we express our strong support for the Pharmacists Fight Back Act introduced by Congressman Auchincloss and Congresswoman Harshbarger. Having witnessed the positive impact of similar PBM reform legislation within Kentucky's Medicaid program and commercial market, we understand the critical importance of extending these reforms to the Federal Medicare program,” said Ben Mudd, Executive Director, Kentucky Pharmacists Association. “This federal legislation is essential to ensure fair and transparent reimbursement practices for all pharmacies nationwide. This bill will protect patient choice and enhance pharmacy access, benefiting patients and the healthcare system as a whole. We commend the efforts of our Congressional leaders and urge swift passage of this vital reform.”

“Unite for Safe Medications wholeheartedly supports the Pharmacists Fight Back Act and is grateful to Representatives Harshbarger and Auchincloss for taking on the unfair practices of PBMs. This legislation is crucial for protecting taxpayers and patients from price gouging and other PBM abuses,” said Loretta Boesing, Executive Director, Unite for Safe Medications. “Moreover, PBMs' exclusion of thousands of community pharmacies from networks like Tricare forces patients to use PBM-owned mail-order pharmacies, reduces patient choice, increases risks associated with obtaining medications, and jeopardizes the survival of local pharmacies that are essential to America’s healthcare system."

“For too long, Pharmacy Benefit Managers (PBMs) have exploited a lack of transparency and accountability to burden patients with higher out-of-pocket costs for life-saving medicines. These intermediaries, who do not contribute to patient well-being, have evaded federal regulation for an extended period,” said Dr. Robert Popovian, Pharm.D., MS, Chief Science Policy Officer, Global Healthy Living Foundation. “The Global Healthy Living Foundation commends bipartisan legislative efforts aimed at ensuring patients can access innovative medicines at reasonable costs without obstacles.”

Read the full text of the bill here: