WASHINGTON, D.C. – U.S. Senator Marsha Blackburn (R—Tenn.) and Mike Braun (R-Ind.) introduced legislation to demand greater transparency for pharmacy benefit managers (PBMs).
“PBMs were intended to increase efficiency and manage drug costs for patients and taxpayers. This is not happening as it should," said Senator Blackburn. "The lack of transparency on the part of PBMs has revealed a broken market and hurts patients, independent pharmacists and taxpayers. This legislation will begin to reverse that trend.”
The Pharmacy Benefit Managers Accountability Study Act of 2021 requires the Government Accountability Office to submit a report on PBMs to the Senate Finance Committee and HELP Committee which will investigate PBMs and provide recommendations for lowering prescription drug prices.
On a state and federal level, concerns have been raised about PBMs. The results of a 2021 Senate Finance Committee investigation found that PBM preferential tactics directly discouraged lower insulin prices.
The GAO Study would address:
- The PBMs’ role in the supply chain;
- The state of competition among PBMs;
- The use of rebates and fees by PBMs, including the amount of the rebate that is passed on to the payer and/or patient;
- The structure of formularies;
- Prior authorization approval times for PBMs;
- Factors affecting the use of step therapy by PBMs; and
- The use of spread pricing by PBMs.