House Judiciary Subcommittee examines pharmacy benefit management tools

The House Judiciary Subcommittee is looking to examine whether pharmacy benefit management (PBM) tools will lower the cost of prescription drugs.

"PBMs reduce costs, expand access and improve the quality of health benefits," PCMA President and CEO Mark Merritt said. "Policymakers should guard against special interest hand-outs to the drugstore lobby that undermine affordable pharmacy networks, formularies and other tools that make prescription drugs more affordable."

The committee, regarding the Committee and Antitrust Law and Regulatory Reform, believes that lawmakers should look at PBMs "in the pharmacy benefit managers and pharmacy marketplaces.”

The committee looked at the 253 million Americans who use health care through their unions, employers or the Federal Employees Health Benefits Program. Other plans include Medicare Part D, Medicaid and state government plans.

PBMs can reduce costs for pharmaceuticals by 30 percent. The reduced costs typically come in the use of generic drugs as well as by negotiating costs with pharmacists and manufacturers.

The Federal Trade Commission wrote a letter last year regarding pharmacy changes. Provisions included in the agency's proposed Medicare Part D rule warned, "The proposed...pharmacy provisions threaten the effectiveness of selective contracting with pharmacies as a tool for lowering costs. Requiring prescription drug plans to contract with any willing pharmacy would reduce the ability of plans to obtain price discounts based on the prospect of increased patient volume and thus impair the ability of prescription drug plans to negotiate the best prices with pharmacies."