Real reforms would help reduce Americans’ prescription drug costs, preserve access to convenient and trusted pharmacies, and confront PBM tactics jeopardizing pharmacies
The National Association of Chain Drug Stores (NACDS) is hailing pharmacy benefit manager (PBM) reforms contained in the 118th Congress’ culminating legislative package, and is urging the U.S. House of Representatives and U.S. Senate to advance this continuing resolution to President Biden’s desk for signature. NACDS – as well as other pharmacy organizations – has identified as “Key Votes” the votes in each chamber.
The PBM reforms particularly critical from pharmacy’s perspective include:
- Medicaid managed care pharmacy payment reform and a ban on spread pricing by requiring 100% pass-through to the pharmacy of the ingredient cost and of the professional dispensing fee, which could allow the federal government and states to save billions of dollars.
- Ensuring fair and adequate Medicaid managed care pharmacy reimbursement from PBMs to cover the cost to acquire and dispense prescription drugs.
- Requiring National Average Drug Acquisition Cost (NADAC) survey participation to help establish benchmarks for Medicaid reimbursement to pharmacies which can be used to ensure fair reimbursement to pharmacies in Medicaid managed care and in the commercial markets.
- Requiring the Centers for Medicare and Medicaid Services (CMS) to define and enforce “reasonable and relevant” Medicare Part D contract terms, including information about reimbursement and dispensing fees, and establishing in Medicare Part D an approach by which “any willing pharmacy” can truly participate and serve patients.
NACDS President and CEO Steven C. Anderson said, “NACDS has been clear throughout the 118th Congress. Americans and their pharmacies need PBM reform; these reforms must be ‘real reforms’ for pharmacy-specific concerns; and Congress needs to get this ‘must-pass legislation’ done. Now, the extraordinary leadership of dedicated legislators is poised to deliver the most significant federal progress ever in addressing PBMs’ ‘pharmaceutical benefit manipulation.’”
Anderson continued, “Congress deserves tremendous credit and thanks for packaging on-point PBM reforms that will help reduce Americans’ prescription drug costs, preserve access to convenient and trusted pharmacies, and confront PBM tactics jeopardizing pharmacies.”
Anderson concluded, “NACDS has emphasized that Congress has done the hard work throughout the 118th Congress to get necessary PBM reforms ready to go, and that Congress needs to finish this job. With these PBM reforms, Congress is two crucial floor votes and a Presidential signature away from a landmark victory for the American people and for sound public policy.”
RELATED CONTENT:
Pharmacy Groups “Key Vote” CR with Real PBM Reforms
December 14 NACDS Release on PBMs’ Ploys to Sabotage Congress’ Hard Work
December 12 NACDS Release on Congress’ Final Push
120 U.S. House Members Call for PBM Reform Now
34 U.S. Senate Members Call for PBM Reform Now
39 State Attorneys General Call for PBM Reform
President-elect Trump on PBM Reform in Two National Media Events in One Week
Biden Administration White House Roundtable
House Oversight and Accountability Committee Report
Federal Trade Commission Interim Staff Report
Poll: PBM Reform is Must-Pass Legislation
National Association of Manufacturers-NACDS Op-ed
Wall Street Journal: November 26, 2024
The New York Times: October 19, 2024
NACDS Explainer Video: #FreeClaire
