May 17, 2023 - Modern Healthcare
Merdie Nzanga
Pharmacy benefit managers would be subject to new transparency rules under legislation that cleared a key House subcommittee on Wednesday.
The Transparent PRICE Act of 2023, approved unanimously by the House Energy and Commerce Committee's Health Subcommittee, would require PBMs to annually provide employers with detailed data on prescription drug spending, including acquisition costs, out-of-pocket spending, formulary placement rationale and aggregate rebate information. The bill also would order the Government Accountability Office to report on group health plan pharmacy networks, including those owned by health insurance companies.
"These solutions will bring much-needed transparency to patients and employers," said Rep. Brett Guthrie (R-Ky.), who chairs the subcommittee. "The legislation would also increase transparency in the prescription drug market and the vertical integration that is taking place in our healthcare system."
The measure moves on to the full Energy and Commerce Committee and, possibly, to the House floor.
PBMs face similar legislative efforts in the Senate to promote transparency and curtail business practices critics say inflate drug costs.
The Senate Health, Education, Labor and Pensions Committee approved the Pharmacy Benefit Manager Reform Act of 2023 in a bipartisan vote last week. That legislation would forbid spread pricing, ensure patients receive the full benefit of drugmaker rebates, disclose prices and dispensing fees, and report how much PBMs earn from pharmaceutical company copayment assistance programs.
In addition, the House Oversight and Accountability Committee launched an investigation into PBMs last month. And the Federal Trade Commission, which commenced an inquiry into anticompetitive activities in the pharmacy benefit manager industry last June, announced Wednesday it has broadened the reach to include PBM-founded group purchasing organizations.