WASHINGTON, D.C. – U.S. Senator Shelley Moore Capito (R-W.Va.), Ranking Member of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS), joined a bipartisan group of 20 colleagues, in sending a letter to Senate Majority Leader Chuck Schumer (D-N.Y.) and Minority Leader Mitch McConnell (R-Ky.) calling for immediate action on reforming pharmacy benefit managers (PBMs) in an effort to reduce the cost of prescription drugs. The letter was led by U.S. Senator James Lankford (R-Okla.).

“Immediate action is needed to address these harmful practices by PBMs. Americans deserve and expect protection from inflated prescription drug costs, forced pharmacy closures, formulary manipulation, and barriers to their pharmacy of choice that result from harmful PBM tactics. We cannot sit idly by while patients suffer. We urge you to work as early as this month to enact specific PBM reforms that address these concerns and capitalize on the bipartisan effort and momentum in the House and Senate,” the senators wrote.

BACKGROUND:

Earlier this year, Senator Capito joined a letter to the Federal Trade Commission (FTC) urging it to complete its investigation into PBMs.

In June of 2023, Senator Capito introduced the Protect Patient Access to Pharmacies Act, to ensure that all pharmacy price concessions are assessed at the point of sale and eliminate the retroactive nature of direct and indirect remuneration (DIR) clawback fees imposed by PBMs.

In March of 2023, the Pharmacy Benefit Manager Transparency Act, which Senator Capito co-sponsored, passed the Senate Commerce, Science, and Transportation Committee where it awaits a full Senate vote.

This letter has the support of the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA), the Food Industry Association (FMI), the National Grocers Association (NGA), and the National Association of Specialty Pharmacy (NASP).

You can read the full letter here or below:

Dear Majority Leader Schumer and Minority Leader McConnell,

We write to call attention to the immediate need to enact pharmacy benefit manager (PBM) reforms to reduce Americans’ prescription drug costs and protect patient access to pharmacies across our country.

Already in the 118th Congress, bipartisan legislation has advanced through several committees, addressing specific PBM practices that for far too long have threatened patient access to low-cost drugs and pharmacies that serve communities nationwide. We have an opportunity now to advance bipartisan legislation that both saves significant taxpayer dollars and also – for the first time – enforces reasonable and relevant terms that ensures pharmacies’ ability to serve patients. There are few issues that unite members of the 118th Congress like reforms that result in savings and accountability.

The Centers for Medicare & Medicaid Services (CMS) recently wrote to PBMs and health plans, saying, “We are hearing an increasing number of concerns about certain practices by some plans and [PBMs] that threaten the sustainability of many pharmacies, impede access to care, and put increased burden on health care providers.” We have heard directly from our constituents that harmful and aggressive tactics of some PBMs continue to worsen year over year, and that action is needed now to protect pharmacies or potential closure is imminent. Many of our constituents report that some PBMs are reimbursing pharmacies even further below the pharmacies’ cost for the prescriptions that they fill – especially in Medicare. Congress must act to ensure proper oversight and transparency.

Immediate action is needed to address these harmful practices by PBMs. Americans deserve and expect protection from inflated prescription drug costs, forced pharmacy closures, formulary manipulation, and barriers to their pharmacy of choice that result from harmful PBM tactics. We cannot sit idly by while patients suffer. We urge you to work as early as this month to enact specific PBM reforms that address these concerns and capitalize on the bipartisan effort and momentum in the House and Senate.

Sincerely,

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