Senators seek results of 18-month federal investigation into Rx middlemen
West Virginia Press Association
WASHINGTON, D.C. – This week, U.S. Senator Shelley Moore Capito (R-W.Va.) joined 13 of her Senate colleagues in urging the Federal Trade Commission (FTC) to complete its investigation into the health care industry’s most powerful prescription drug middlemen: Pharmacy Benefit Managers (PBMs). This bipartisan effort, led by U.S. Senators Chuck Grassley (R-Iowa) and Maria Cantwell (D-Wash.), includes requesting a status update on the investigation, which has now been open for over 18 months.
“We support the [FTC’s] issuance of a Section 6(b) order and conducting a timely study of pharmacy benefits managers’ (PBM) business practices,” the senators wrote in their letter to FTC Chair Lina Khan. “With the FTC’s inquiry reaching its year-and-a-half mark, we urge the FTC to complete the study without delay. In the interim, we believe it is important to know the status of the study and therefore ask the FTC to issue a progress report.”
BACKGROUND:
PBMs manage every aspect of the prescription drugs benefit process – from setting prescription prices, to deciding which drugs insurance plans cover and how they are dispensed. Of the six companies under FTC investigation, three control nearly 80% of the market. Despite PBMs’ sweeping influence, neither Congress nor the taxpayer has adequate visibility into their operations. By shining a light on PBMs, Senator Capito and her colleagues are working to identify causes for the skyrocketing prices patients are paying for their prescriptions, as well as solutions to address them.
In June of 2023, Senator Capito introduced the Protect Patient Access to Pharmacies Act, to ensure that all pharmacy price concessions are assessed at the point of sale and eliminate the retroactive nature of direct and indirect remuneration (DIR) clawback fees imposed by PBMs. This legislation will help ensure local pharmacies remain open and Medicare patients will continue to have access to the medications and information they need from the pharmacists they trust.
In March of 2023, the Pharmacy Benefit Manager Transparency Act, which Senator Capito co-sponsored, passed the Senate Commerce, Science, and Transportation Committee where it awaits a full Senate vote.
Full text of the senators’ letter can be found here.