WASHINGTON—House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) today spoke at an event hosted by The Hill which focused on bipartisan efforts at reforming certain Pharmacy Benefit Manager (PBM) practices. In his remarks, Chairman Comer highlighted the House Committee on Oversight and Accountability’s work to bring accountability for harmful PBM practices which raise costs on American consumers and have a negative impact on independent pharmacies.
Earlier this year, the Committee passed—with broad bipartisan support—the Delinking Revenue from Unfair Gouging (DRUG) Act which would reign in practices by some PBMs that offer health plans under the Federal Employees Health Benefits program.
One of the things that the Committee has been investigating is the practice of PBMs. What have you learned from that investigation?
“We’ve got a lot of problems with the way PBMs operate. In a bipartisan way, we believe that PBMs are operating in an anticompetitive manner. PBMs were created, like most entities, through legislation with good intentions, but overtime unintended consequences have happened.
“Because of consolidation, you have three major PBMs that control eighty percent of the market. Those three PBMs also are owned by health insurance companies. Now they own their own mail-in pharmacies. They’ve become vertically integrated, and they’ve had a negative impact on the costs of prescription drugs for consumers.
“I believe PBMs have had a negative impact on competition, especially among community pharmacists. I believe they have an unfair competitive advantage. I believe they’re doing a lot of things that are unethical at best and should be illegal at worst with respect to – I would even go as far to say as extorting – fees from independent pharmacies. We’re losing independent pharmacies.”
“We’ve had a couple of very good hearings and we’ve requested and received over 40,000 pages of documents. We’re trying to issue a report very soon and we’ll have another hearing to talk about the report and steps moving forward. […] We’ve shown leadership in the House Oversight Committee on this issue and hopefully we can make a difference.”
What is the path for PBM reform?
“I think everyone in America, we recognize that the cost of prescription drugs is on an unsustainable path to the average American.”
“We moved our part of the legislation on the Oversight Committee. The Oversight Committee has jurisdiction over the federal workforce. We took that portion of the bill and tried to demonstrate leadership to get momentum to try to get Congress to act.
“The encouraging thing from a Congressional standpoint is we have so many state legislators, whether they be Democrat or Republican, that are stepping up to try to reform PBMs, especially as it affects Medicaid.
“The focus of what PBMs role should be to help the consumer have more choice, have lower costs. But what’s happening is the focus now is which drug can we make the most profit off of, regardless of what’s best for the patient.
Would you like to see the White House get more involved?
“As more people in America understand what has happened over the last five or six years with respect to PBMs and their profits, and what they’ve done to independent pharmacies, and what they’ve done to the cost of health care and the cost of prescription drugs in particular, I think there would be more support for PBM reform, and a bigger push.”