NCPA supports proposal for adopting PBM transparency

Sep 23 2009

The National Community Pharmacists Association (NCPA) today praised U.S. Sen. Maria Cantwell (D-WA) for authoring an amendment to lower health care costs by adopting common-sense disclosure requirements for any pharmacy benefit manager (PBM) participating in the health insurance exchanges envisioned under a proposal by Sen. Max Baucus (D-MT). The Senate Finance Committee, chaired by Sen. Baucus, is expected to vote this week on the amendment and the underlying bill, the America’s Healthy Future Act.

“We commend Senator Cantwell for standing up for patients and we urge Senators to support this proposal to drive down health care costs,” said Bruce T. Roberts, RPh, NCPA Executive Vice President and CEO. “For too long, a shroud of secrecy has allowed these companies to pocket large portions of both the transactions they process as well as the rebates paid by manufacturers. Patients and plan sponsors are footing the bill in the form of higher insurance premiums while PBM profits soar – up 20 percent last year alone. Public and private plan sponsors are increasingly insisting on PBM transparency for good reason.”

The Cantwell amendment would require PBMs operating in a health insurance exchange to provide basic aggregate information so that health plan sponsors can make educated decisions about which PBM, if any, offers the best value for the plan and patients.

In July, the House Energy and Commerce Committee approved a similar amendment, by Rep. Anthony Weiner (D-NY), to its health reform plan (H.R. 3200). The Congressional Budget Office indicated to House staff that the disclosure provision would reduce federal spending.

Consumer groups also back PBM reform and, in June, a top government auditor testified that there's a “good chance” taxpayers and participants in the Federal Employee Health Benefits Program are “not getting a good deal because of the lack of transparency” by PBMs.