Bipartisan Interest in Changing PBM Business Practices Continues to Grow

The year after President Joe Biden signed the Inflation Reduction Act (IRA) into law, policymakers have now focused their efforts on PBMs and their business models. Members of Congress on both sides of the aisle have introduced multiple bills focusing on issues such as the lack of transparency into PBM practices, spread pricing, direct and indirect remuneration (DIR) clawbacks, rebates and anticompetitive behavior. And some industry experts say they are hopeful that such legislation could improve transparency around drug pricing, including in the high-cost specialty arena.

There was much talk but little action around bringing down prescription drug prices during the previous administration, which floated tactics such as implementing a most-favored-nation model that would have tied drug prices in Medicare Parts B and D to other countries’ prices, lowering prices for insulin and distributing $200 prescription drug credits to Part D beneficiaries.

© 2024 MMIT
Angela Maas

Angela Maas

Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. She also has written for Spotlight on Market Access since its 2017 launch. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at Hem Aware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.

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