Fiscal Instability’s Post

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

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

Sorry if you're squeamish, but check out the latest TV spot from National Community Pharmacists Association (NCPA), currently running in the D.C. market as part of their "Finish the Fight" campaign that kicked off last week, aiming to push Congress to finalize PBM reform as soon as possible this year. While launching the campaign on Thursday, we also released the results of a new poll revealing widespread public concern over prescription drug costs and PBMs. Among our findings? Nearly 75 percent are concerned about PBMs’ impact on drug pricing, and 60 percent said they’d be more likely to vote for a someone who supports legislation aimed at addressing PBM abuses. With elections right around the corner, this is valuable information to have when talking with policymakers – or would-be policymakers! – about their legislative priorities. https://lnkd.in/gf9_w7yR #FinishtheFight #NCPA #PBMreform #pharmacy #pharmacies #healthcare

Tuesday's FTC oversight committee hearing on Pharmacy Benefit Managers (PBMs) shed light on critical issues affecting drug pricing and patient care. Key discussions included concerns about transparency in PBM operations, the impact on medication access, and the need for regulatory reforms. Stay tuned for updates as we continue to advocate for change! 💊💡 https://lnkd.in/eZWRT4_D #PBMHearing #PatientAdvocacy #DrugPricing

📢 ADVI Health recently welcomed Zachary Friend to the team as senior associate, federal and state policy. At ADVI, Zack works with clients to help them better understand how the implementations of the #InflationReductionAct (IRA), state-level Prescription Drug Affordability Boards (PDABs), and other #Medicare Part D policies will impact their businesses and products. Read more on Zack and his experience: https://lnkd.in/eqn_5inv

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.

As the battle rages on between legislators in power (collectively the government) and the pharmacy benefits industry ---providers (pharmacies, medical) and patients are caught in the cross fire. Has the vertical consolidation made the largest institutions too big too fail and too big to regulate? Will things have to get worse for anything to significantly change? How much more money will be wasted in the Medical-Industrial complex without improving access, affordability, and quality of care?

🚨 NACDS is calling attention to today’s The New York Times must-read and must-act article: “The Middlemen: The Opaque Industry Secretly Inflating Prices for Prescription Drugs; Pharmacy benefit managers are driving up drug costs for millions of people, employers, and the government.” The article, described as “the first article in a series about how pharmacy benefit managers prioritize their interests, often at the expense of patients, employers and taxpayers,” lays out the devastating effects of PBM tactics and manipulation on people and on the pharmacies that communities rely on nationwide - making the push for Congress to deliver on #PBMreform even more salient. Read: https://bit.ly/4bfHnj6

This is HUGE. In the U.S., nearly 80% of prescription claims are processed by three "Pharmacy Benefits Managers (PBMs)" - Caremark (CVS), Express Scripts (Cigna), and Optum Rx (UnitedHealth Group). Together, they dominate the lucrative pharmaceutical supply chain and manipulate it to their financial benefit. Now this - according to STAT News and other media outlets reporting today: "The U.S. Federal Trade Commission filed a lawsuit against the largest pharmacy benefit managers and their group purchasing organizations for allegedly anticompetitive practices that 'artificially inflated' the price of insulin and, consequently, impeded patient access to the life-saving treatment. The administrative complaint accused CVS Caremark, Cigna’s Express Scripts, and UnitedHealth’s OptumRx of creating a “perverse” system of rebates that favored insulin that was sold at higher list prices in order to 'line their pockets' at the expense of patients, who were forced to pay more for the medication." I wish the FTC success, and I implore Congress, the Biden Administration and whoever occupies the White House following the upcoming Presidential election to break the stranglehold 'Big Health' has established on U.S. healthcare. This is a stark example of the harm it causes patients, employers, and our nation's economy. #health, #PBMs, #FTC

🚨 PBMs Are Driving Up Your Prescription Costs! 🚨 Pharmacy Benefit Managers (PBMs) are inflating prescription prices while pocketing billions, and it's time to put a stop to it. These drug middlemen are raking in huge profits while you're left paying more. Let’s demand real reform that puts patients first. Tell Congress to take action NOW! Click the link below to join the fight against these "fat cats" and help pass PBM reform legislation. 👉 Take Action Now: https://lnkd.in/gh8RQ4EP #Fight4Rx #PBMReform #StopTheMiddlemen #SupportLocalPharmacies #HalifaxPharmacy #SouthBostonVA