The following is a statement from Angus Worthing, MD, ACR Government Affairs Committee Chair:
“As policy makers and healthcare professionals continue to work together on ways to lower drug costs for patients, the ACR has worked to educate leaders in Congress about the lack of transparency from pharmacy benefits managers (PBMs) on the savings they are negotiating and whether those are being passed to patients. Though PBMs claim to use their position to negotiate lower drug prices, there has been no proof that rebates have been used to reduce the burden on patients and the healthcare system at large.
In recent years, several states have enacted legislation to hold PBMs accountable and crack down on secretive practices that drive up costs for consumers. State legislation has included gag clause bans, restrictions on claw-back provisions in PBM-insurer contracts, licensure of PBMs in states where they operate, and provisions that protect community pharmacies from unfair PBM auditing practices. These are positive developments, but without the full disclosure of rebates and discounts it is not possible to determine how the rebate system impacts drug prices and patient costs.
The ACR is concerned that the federal district court’s recent decision to approve the merger of CVS Health Corporation and Aetna hinders progress that has been made towards creating transparency and will make it easier for costs savings to remain secret. We hope that regulators will now actively watch the conduct of the merged company to ensure patients are protected.”