Patients Before Monopolies Act | PBM Reform Podcast
Update: 2024-12-20
Description
In this critical episode of the PBM Reform Podcast, we are joined by two influential voices leading the charge against abusive pharmacy benefit manager (PBM) practices:
Topics Discussed:
Call to Action:
Resources & Links:
- State Representative Jake Auchincloss – Congressman from Massachusetts’ Fourth District
- Greg Reybold – Vice President of Healthcare Policy & General Counsel, American Pharmacy Cooperative, Inc.
Topics Discussed:
- The "Pharmacists Fight Back Act" (HB 9096):
- Legislation Overview:
- The bill proposes a transparent pharmacy reimbursement model based on:
- Market-based pricing benchmarked to the National Average Drug Acquisition Cost (NADAC) plus a dispensing fee equivalent to each state’s Medicaid reimbursement or the lesser of 2% or $25.
- Eliminating PBMs’ ability to restrict patient choice through network exclusions.
- Ensuring rebate pass-throughs to patients directly at the pharmacy counter.
- Prohibiting PBM practices that steer patients toward PBM-owned pharmacies, protecting community pharmacists and preserving patient choice.
- The bill proposes a transparent pharmacy reimbursement model based on:
- Guest insights on how HB 9096 seeks to end exploitative PBM tactics and its potential impact on independent pharmacies nationwide.
- Legislation Overview:
- The "Patients Before Monopolies Act":
- Bipartisan Efforts:
- Introduced by Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) to dismantle PBMs’ monopoly power.
- Co-sponsored by Representatives Jake Auchincloss (D-MA) and Diana Harshbarger (R-TN).
- Introduced by Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) to dismantle PBMs’ monopoly power.
- Key Goals:
- Break up PBM ownership structures that lead to conflicts of interest.
- Ensure fair reimbursement practices for all pharmacies, reducing patient drug costs and increasing healthcare access.
- Discussion on the broader implications for federal programs and the pharmacy industry at large.
- Bipartisan Efforts:
- PBMs and Their Role in Driving Up Drug Costs:
- Exploring how PBMs contribute to higher drug prices and diminished patient choice.
- The detrimental effects of PBM practices on independent community pharmacies and patients enrolled in federal healthcare plans.
Call to Action:
- Contact your legislators to express support for the Pharmacists Fight Back Act (HB 9096) and the Patients Before Monopolies Act.
- Share this episode to spread awareness of the critical need for PBM reform.
Resources & Links:
- Learn more about HB 9096 and its provisions:
- Support the Patients Before Monopolies Act:
- References:
Intro piece: "Senators Warren and Hawley introduce a bipartisan bill to break up pharmacy-benefit managers" via CNBC Television
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