![Congress versus PBMs](/sites/default/files/styles/blog_page/public/blog-post/TL_Congress%20vs.%20PBMs_v2.jpg?itok=nvCY2Xnz)
By Lari Harding, Senior Vice President, Healthcare Marketing and Sales Enablement:
Because of the efforts of NACDS RxIMPACT I was able to watch the July 23 Congressional Hearing on the Role of Pharmacy Benefit Managers in Prescription Drug Markets. What I took away was informative and encouraging on three fronts; the first, our country is engaging on the need to improve the way healthcare operates. Second, acknowledgement that we need to focus on improving health, not treating sickness in the United States. And third, it gave me hope that needed legislative action may be coming.
The hearing, convened by the House Committee on Oversight and Accountability, was the Committee's third hearing on PBMs and a continuation of the Committee's investigation into PBMs that launched in March of 2023. This particular hearing was focused on Transparency and Accountability with the CEOs of the three largest PBMs called to testify.
Whatever your politics, you'd have to acknowledge (admire? applaud?) the unflinching tone with which Representative James Comer, chair of the Committee, opened the hearing.
From his bracing summary of PBM-disparaging testimony gathered in previous hearings to his overview of the Committee's new report that found PBMs enacting "anti-competitive policies" that "hurt taxpayers and reduced patient choice" to his first pressing question to David Joyner, president of CVS Caremark, regarding the recent court judgment against the company over DIR fees, it was evident that Mr. Comer was coming hard at all the witnesses. And he never let up, nor did any of the committee members.
When the witnesses' answers to his next two questions regarding PBMs steering patients toward the mail order pharmacies they operate and the myriad prices they charge for the same medications across multiple markets didn't satisfy his queries, he let the responding executives know and answered the questions himself. I'm not sure that constitutes recognized parliamentary procedure but, honestly, it felt good to hear.
In the third hour of the hearing which lasted almost five hours, Congresswoman Lisa McClain attempted to cut through the stock answers coming from the PBM executives by stating that both pharmacists and patients think there is a problem -- pressing them to answer if they agree there is a problem. She also requested additional data from all of the PBMs because, as she put it, her prior requests have brought in "sales pitches and marketing materials, but not data." She ended with this statement, "I'll just share with you where this is going to end. This is going to end at the PBMs being out of business, and the only people you have to blame for that is yourself."
What followed left me with the impression that Congress is genuinely committed to change and I'm going to hold on to that feeling for as long as possible. The economic conditions for pharmacies today need to change to protect access for Americans.
Representative Comer is just one member of the House Committee on Oversight and Accountability. On this day, he earned a "thank you" -- at least from me. I'll save my next accolades for all of Congress when they pass meaningful PBM-reform legislation.