NACDS to U.S. Congress: Real PBM reform must include Medicare and Medicaid

An NACDS video urges the U.S. Congress that PBM reform must include Medicare and Medicaid.

7/28/2023

The National Association of Chain Drug Stores is reminding the U.S. Congress that real and comprehensive pharmacy benefit manager reform must include Medicare and Medicaid.

A video message by NACDS president and CEO Steve Anderson underscores the importance of the Committee’s work for delivering true reform of pharmaceutical middleman tactics—given its jurisdiction over Medicare and Medicaid.

Anderson states in the video: “There are no two ways about it. Real PBM reform must include Medicare and Medicaid. The U.S. Congress has a chance to stop pharmaceutical benefit manipulation. It has a chance to stop the tactics of middlemen that drive up drug prices and restrict pharmacy access, so Congress cannot settle for reform in name only. Medicare and Medicaid patients—and their pharmacies—need PBM reform.”

The release of the video follows a July 13 statement by NACDS commending the U.S. Senate Committee on Finance for scheduling action on PBM reform, in which Anderson said, “NACDS appreciates the bipartisan leadership of Senate Finance Committee Chair Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Ind.) to deliver on PBM reform. Importantly, in the U.S."

Anderson continued, "Congress, we are seeing bipartisan commitment and work across the Senate and House of Representatives to provide meaningful reform for patients and for the pharmacies that serve them. As the Senate Finance Committee considers its legislative package, NACDS emphasizes the crucial importance of two bills that are consistent with the Senate Finance Committee’s Bipartisan Framework for Reducing Prescription Drug Costs: the Drug Price Transparency in Medicaid Act (S. 1038) and the Protect Patient Access to Pharmacies Act (S. 2052). Specifically, the bills would deliver essential reforms in Medicaid and Medicare. S. 1038 and S. 2052 are vital for real PBM reform, and for addressing ‘pharmaceutical benefit manipulation’ that harms the most vulnerable in the Medicaid and Medicare programs.”

Overall, NACDS is advocating for comprehensive PBM reform across all payer segments, consistent with NACDS’ Principles of PBM Reform. Direct and indirect remuneration fee reform remains an important aspect of PBM reform.

NACDS’ Principles of PBM reform include: stopping explosive retroactive fees; stopping below-cost reimbursement; stopping the gaming of performance measures; stopping “specialty definitions” from steering patients from their pharmacy; stopping mandatory mail-order; stopping limited networks; stopping overwhelming audits; and stopping the undercutting of PBM reform laws.

NACDS said it looks forward to continuing work with leaders in the U.S. Congress to deliver the essential reforms that are critical for patients’ pharmacy access, for the viability of pharmacies, for lower drug prices, for patients’ freedom to choose their pharmacy and for patients’ access to medications that are right for them.

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