EmpiRx Health’s Post

The National Association of Chain Drug Stores (NACDS) is making it unmistakable: #PBMreform is must-pass legislation in the 118th Congress ❗️ NACDS President and CEO Steven C. Anderson 💬: It’s time for Congress to reduce patients’ drug costs, to stop PBMs from forcing pharmacies to fill prescriptions at a loss, and to ensure Americans can access the pharmacies and medications that are right for them.” “If the 118th Congress closes its doors without enacting these reforms, they’re closing the doors on Americans and pharmacies…Congress needs to stand strong and get this done.” NACDS emphasizes that all branches of government at the federal and state levels must act to bring about comprehensive PBM reform and that Congressional action in the 118th Congress is essential.

Congratulations to James Comer (U.S. House of Representatives) and the House Oversight Committee for pushing this incredibly important piece of legislation through. In a significant move towards ensuring fairness and transparency in the pharmaceutical industry, The Delinking Revenue from Unfair Gouging (DRUG) Act seeks to redefine how pharmacy benefit managers (PBMs) operate within federal health benefits plans. This pivotal legislation requires PBMs to "de-link" their fees charged to insurers from the price of drugs, a step forward in dismantling the opaque pricing models that have long plagued our system. At AffirmedRx, we stand firmly in support of the DRUG Act's mission. We've always believed that the value we bring to our partners and their beneficiaries should not be tied to the costs of medications but rather to the quality and integrity of the service we provide. This legislation aligns with our core values and operational model. We've demonstrated that it's not only possible to offer comprehensive PBM services without relying on the traditional fee structures tied to drug prices, but it's also more effective in promoting health equity and access. The DRUG Act presents an opportunity for all PBMs to step up and embrace a model that prioritizes patients' health and financial well-being over profits. As discussions around the DRUG Act continue, we want to reassure our clients and their members that we remain committed to leading the way in transparent, ethical PBM practices. We see this not as a challenge to our business model but as a confirmation of its necessity and value. We call on our peers in the industry to join us in this pivotal moment. Let's work together to ensure that the future of pharmacy benefits management is built on fairness, transparency and a commitment to the well-being of all patients. #AffirmedRx #PharmacyBenefits #PBM #PBC #DRUGAct #TransparencyInHealthcare #HealthcareReform Representative Jim Jordan Representative Michael Turner Representative Virginia Foxx Glenn Grothman @Representative Michael Cloud Representative Gary Palmer Representative Clay Higgins Representative Andy Biggs Nancy Mace @Representative Jake LaTurner patrick fallon @Representative Byron Donalds Scott Perry @Representative William Timmons @Representative Tim Burchett @Representative Lisa McCain Representative Lauren Boebert @Representative Anna Paulina Luna @Representative Mike Waltz @Representative Gerry Connolly Representative Raja Krishnamoorthi Representative Ro Khanna Representative Kweisi Mfume @Representative Katie Porter Representative Mike Garcia @Representative Maxwell Frost @Representative Rashnida Tlaib @Representative Jamie Raskin Pittsburgh Business Group on Health Ovation Healthcare Hospital Association of Southern California (HASC) Kentucky Hospital Association Kentucky Association of Manufacturers Mark Cuban Cost Plus Drug Company, PBC https://lnkd.in/d7SwYbFF

Two bills, H945 and H934, are currently gaining traction in the Massachusetts House. H945 aims to implement prescription drug cost transparency and affordability by requiring Pharmacy Benefit Managers (PBMs) to disclose their financial agreements and pricing practices. H934 focuses on compensation reform for PBMs, mandating disclosure of their compensation structure to prevent unfair pricing practices and enhance affordability. Read more about the latest national and state #workerscomp updates in our State of the State blog: https://bit.ly/3QRGIxd #WorkersCompensation #BeFreeWithIWP

“It's like a balloon. When a squeeze inflates drug costs in one place, you have to reign them in somewhere else." So begins a recent HealthLeaders piece by Mandi Poplawski, VP of Pharmacy Management for CareFirst BlueCross BlueShield. She summaries the pressurized landscape of prescription drug costs in the U.S., the latest squeeze being the Inflation Reduction Act (IRA). Read how she believes the IRA is "the largest change to the Medicare Part D program since its inception in 2006," and how lower drug costs under the IRA will drive higher costs elsewhere -https://lnkd.in/eWdFRtNQ With change comes uncertainty. Reach out to us to learn how we can help quantify and optimize risk-sharing to improve market access - https://lnkd.in/eVF_4DBY #HEOR #IRA #DrugPricing 

Momentum is building as more leaders are coming together to discuss #PBMreforms! Yesterday, the White House held a roundtable discussion with leaders like HHS Office of the Secretary, Federal Trade Commission Lisa Khan, and Mark Cuban. Tomorrow, The Hill will host its own discussion on this critical issue with leaders and experts including Reps. Jake Auchincloss and James Comer, Antonio Ciaccia, Mariana Socal, James Gelfand, and Amy Hinojosa. We hope to see urgent action on reforms that will lower American’s out-of-pocket costs for prescription drugs. #PBMs #prescriptiondrugs #healthcarepolicy #drugpricing https://lnkd.in/gBXVHFd5

The industry is still a few years away from knowing the full impact that the Inflation Reduction Act will have on drug prices. But some critical provisions have already impacted drug plan sponsors for 2024. Our team has identified five areas that Medicare Advantage plans should consider when shaping their 2025 Part D strategy > https://owy.mn/47fU7EF #OWActuarial #Medicare #MedicareAdvantage