Coalition urges tougher PBM rules as Congress weighs final reform bill

ALEXANDRIA, Va. A broad coalition of consumer and labor interest groups is putting new pressure on Congress to force new transparency requirements on the pharmacy benefit management industry.

The coalition, comprised of 24 interest groups, appealed Thursday to leaders in the House and Senate for tougher laws governing PBMs as Congress works to reconcile massive health-reform bills already passed by both chambers. Among the group’s members: the Consumer Federation of America, the U.S. Public Interest Research Group, the National Women's Health Network and the National Legislative Association on Prescription Drug Prices.

The 24 organizations sent a jointly-signed letter, dated Jan. 13, to House Speaker Nancy Pelosi, D-Calif., and Senate majority leader Harry Reid, D-Nev. They’re urging the two congressional leaders to combine PBM transparency provisions already included in each health reform proposal as the Democrats work to hammer out a compromise bill to send to President Obama.

In their appeal, the groups assert that forcing PBMs to open their business and pricing arrangements to scrutiny would prove “a key component in curbing healthcare spending.

“It gives health plans and consumers the tools they need to ensure that their money is well spent, and that the [insurance] plan receives a reasonable portion of the savings and rebates accrued by the PBM on their behalf,” the coalition told Pelosi and Reid. “Large plan sponsors with the bargaining power to demand transparency have enjoyed considerable savings as a result.”

The group’s appeal gained an immediate endorsement from Bruce Roberts, EVP and CEO of the National Community Pharmacists Association and one of the PBM industry’s most vocal watchdogs. “PBMs' secretive, profit-padding practices are creating greater health care costs for everyone else,” Roberts asserted Thursday. “These transparency provisions, while modest, represent the most sweeping federal regulation of PBMs yet.”