Among the most complex but significant issues in the unfolding debate about prescription drug pricing reform is pharmacy benefit manager (PBM) rebates — or, so-called “rebates” — as many objective observers see them as kickbacks or opaque pay-offs to others in a constantly shifting, ‘wild-west’ drug supply chain.
Yeah, it’s complicated — very complicated. Most members of Congress and health staffers themselves are mesmerized and confused about the rebate morass, which requires untangling, transparency and simplification.
Senate Finance Chairman Chuck Grassley (R-IA) recently stepped forward calling for increased examination of PBM “rebates” and the rationale and process behind them. It’s always the same question: Where did the money go?
An interesting development on this front is the positive sentiment offered by Grassley regarding Ranking Member Ron Wyden’s (D-OR) “Creating Transparency to Have Drug Rebates Unlocked Act.”
Wyden’s bill, referred to as the “C-Thru Act”, would require PBMs to publicly disclose aggregate rebates they receive from drug makers and what percentage actually goes to Medicare beneficiaries. The bill would later require a minimum percentage of rebates be passed from PBMs to health plans, and would base beneficiary cost-sharing in Medicare Part D on net prices.
Grassley plans to discuss Wyden’s C-THRU Act this session with the committee, a spokesman for the senator recently told Inside Health Policy.
“Chairman Grassley has said PBMs lack transparency and how they work is too much of a mystery. Chairman Grassley agrees with many of the goals in Ranking Member Wyden’s legislation and will discuss it further within committee,” the Grassley spokesman said.
Small developments such as this reported in key trade press outlets like IHP can end up having big-time implications to a multitude of pharmaceutical business entities’ bottom lines.
Full disclosure: one of my clients’ interests regards achieving pbm rebate reform/transparency, but I raise this IHP blurb to emphasize another reason it’s significant:
Landing on the radar screen of a dogged Grassley examining what appears to be his gut sense PBMs are ‘bad actors’ is just one more negative variable when it comes to PBMs’ ability to manage their collective industry information flow. Which is already problematic.