PBM and Part D Reform Could Be on Legislative Agenda

March 25

As a new bill introduced by Sen. Bernie Sanders (I-VT) indicates, Congress is once again looking seriously at tackling drug pricing reform. D.C. insiders say that Democrats could pursue big changes to PBM regulation and Medicare’s ability to negotiate drug prices, likely through a budget reconciliation bill, and suggest that parts of previous pieces of legislation, such as the 116th Congress’ H.R. 3, are likely to serve as templates for a new bill.

While previous proposals are likely to be where the conversation starts, experts say that Congress is unlikely to pass all of the reforms proposed in existing bills. Those include H.R. 3, the new bill from Sanders and a Senate bill sponsored by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) — though all components of each bill contain elements that a new measure could include.

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Radar on Drug Benefits

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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