Wyden “C-Thru” Bill Helps Pull Back Curtain on Duplicitous PBM “Rebates,” Suspect Pricing Schemes, Related Anti-Competitive Behavior

DATE: March 16, 2017

SCPC Endorses Wyden Legislation; Slams PBM Advocacy Group Response to Oregon  Lawmaker’s Bill

Washington, DC — Noting a torrent of bipartisan legislation recently introduced requiring Pharmacy Benefit Manager (PBM) drug middlemen to pull back the curtain on veiled, opaque pharmaceutical pricing practices, the Senior Care Pharmacy Coalition (SCPC) today backed Sen. Ron Wyden’s (D-OR) “Creating Transparency to Have Drug Rebates Unlocked Act” (C-THRU) bill. The legislation requires PBMs — for the first time — to publicly disclose data regarding “rebates,” “discounts” and other accrued payments — and their impact on Medicare Part D beneficiaries and the Part D program overall.

“PBMs are under heavy scrutiny on both sides of the aisle due to their stubborn, blanket and unjustifiable resistance to transparency — and SCPC strongly supports Senator Wyden’s ‘C-THRU’ bill as a way to lift the veil of secrecy surrounding PBM behaviors that result in higher costs to consumers and lower savings for the Medicare program,” said Alan G. Rosenbloom, President and CEO of SCPC, which advocates for the nation’s long term care (LTC) pharmacies.

Continued Rosenbloom, “Senator Wyden is precisely correct in his observation that ‘the public knows virtually nothing about whether PBMs are saving money for the consumer or pocketing it themselves’.” The SCPC President and CEO pointed to a damaging January 2017 Centers for Medicare & Medicaid Services (CMS) report finding that drug companies, wholesalers and pharmacies are paying larger rebates and hidden fees to PBMs and insurers — but that PBMs are keeping the money rather than translating it into lower costs for beneficiaries or government health care programs.

Wyden’s bill follows on the heels of CMS Administrator Seema Verma’s pledge to Senate Finance Committee members that she will review PBM practices.

SCPC also slammed yesterday’s negative response to Wyden’s bill from the Pharmaceutical Care Management Association (PCMA) — the PBM industry’s primary advocacy organization — saying PBMs only support “the right kind of transparency” and that Senator Wyden’s view of greater transparency would increase beneficiary and program costs. Said Rosenbloom: “PCMA’s viewpoint is illustrative of the PBM industry’s biggest problem: they put themselves and their interests ahead of consumers’ health care and financial interests.”

Phil Fogg, Jr., National Chairman of SCPC, and CEO of Milwaukie, OR-based Marquis Companies and Consonus Health Care, praised Wyden: “Senator Wyden’s ‘C-THRU’ bill helps further a key SCPC organizational priority of ensuring that lawmakers have a better understanding of the value LTC pharmacies bring to the table through clinical and consultative services that improve patient outcomes, and lower overall government expenditures. We look forward to working with Senator Wyden and others to publicize PBM activities that hinder our efforts to improve care quality and reduce costs.”

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The SCPC is the national association for independent LTC pharmacies. Our member pharmacies provide care and services to patients in LTC facilities in across the country occupying approximately 675,000 beds across the country.  Visit us at www.seniorcarepharmacies.org to learn more.