AARP, Pharmacists Endorse Cantwell Bill to Combat Rising Prescription Drug Costs and Unfair Practices by PBM Drug Industry Middlemen
October 13, 2023
Widely supported bill would increase transparency in drug pricing & direct FTC to hold PBMs accountable for manipulation
VIDEO | AUDIO | TRANSCRIPT | PHOTOS
Yesterday, U.S. Senator Maria Cantwell (D-Wash.), Chair of the Senate Committee on Commerce, Science and Transportation, held a press conference at the Othello Station Pharmacy in Seattle with AARP to call attention to the rapid rise of prescription drug costs and called on the Senate to pass her bipartisan Pharmacy Benefit Manager Transparency Act to increase transparency and hold pharmacy benefit managers (PBMs) accountable for deceptive and unfair practices that drive up prescription drug costs and force independent pharmacies out of business. The bill awaits Senate passage.
“If we allow PBMs to keep going at the rate they're going, other pharmacies…will close and people will have less access, less information and certainly more expensive drugs,” said Sen. Cantwell. “We just can't afford it.”
“For someone with diabetes, [skipping] insulin is not an option. And while I'm glad we were able to pass federal legislation that helps seniors deal with these insulin costs, it's time that we do something else to help other citizens who are suffering from these high costs. That is why Senator Grassley and I introduced the Pharmacy Benefit Manager Transparency Act, Senate Bill 127, which is being endorsed today by AARP,” Sen. Cantwell continued. “Senator Grassley and I have about 10 other colleagues who are supporting this legislation and we want the Senate to take up this bill this year.”
At the event, AARP WA Advocacy Director Cathleen MacCaul announced the organization’s endorsement of Sen. Cantwell’s Pharmacy Benefit Manager Transparency Act to increase drug pricing transparency and hold PBMs accountable for unfair and deceptive practices that drive up costs at the expense of consumers. Read AARP’s endorsement letter HERE.
“Thank you…to…Senator [Cantwell] and Senator Grassley for this bipartisan PBM bill,” said MacCaul. “This is significant, because it will allow more older adults to get the prescription drugs that they need to be able to live out their lives. And we're calling into question the business practices that have been going on for a very long time. And we're saying no more. We're saying it's time for transparency, it's time for accountability, and we are not going to put up with it anymore.”
A 2022 survey found that 1 in 4 Washington state residents rationed or skipped medication refills due to rising costs. Local pharmacists described the role their businesses play in communities and the challenges that PBM business practices create.
“We have over seven different languages that are spoken here at this location in our pharmacy. We serve a very diverse population,” said Dr. Ahmed Ali, Pharmacist and Owner of Othello Station Pharmacy. “Most of them walk into this pharmacy because they don’t have the ability to go drive to far [away] places to go get their medications…People trust an independent pharmacy like ours…it’s a hub for folks to come in and have conversations with us.”
Ryan Oftebro, Principal and Chief Executive Officer of Kelley-Ross Pharmacy Group, explained how PBMs increased drug costs for patients and assessed retroactive fees to his pharmacy.
“In 2018, our pharmacy had $81,000 clawed back from PBMs in the form of retroactive fees,” said Oftebro. “In 2021, it increased to over $538,000 – at a single pharmacy. This was money the PBM pocketed by creating artificial patient overpayments. This was abusive to patients and unsustainable for our pharmacy and we were forced to close our doors.”
Dr. Ali noted that a nearby independent pharmacy that served the Southeast Asian and Vietnamese community for the last 25 years recently shut down because of low reimbursement rates.
Sen. Cantwell reintroduced the Pharmacy Benefit Manager Transparency Act with Sen. Chuck Grassley (R-Iowa) in January. Sen. Cantwell successfully passed the bill 18-9 through the Senate Commerce Committee in March and vowed to keep fighting until it becomes law. The Committee heard testimony in February from a pharmacist, oncology doctor and experts who explained how PBMs pervade nearly every aspect of the drug distribution system – from setting prices, deciding what drugs a plan can cover and determining pharmacy reimbursements. According to a preliminary estimate by the Congressional Budget Office, the legislation would reduce the deficit by $740 million over the next 10 years. Read a summary of the bill HERE.
This bipartisan bill is also cosponsored by Sens. Jon Tester (D-Mont.), Cindy Hyde-Smith (R-Miss.), Mike Braun (R-Ind.) Jerry Moran (R-Kan.), Thom Tillis (R-N.C.), Shelley Moore Capito (R-W.Va.), John Boozman (R-Ark.), Peter Welch, (D-Vt.), Marshall Roger (R-Kan.), Martin Heinrich (D-N.M), Joni Ernst (R-Iowa) and Mike Rounds (R-S.D.).
PBMs currently operate in the dark without pricing transparency. Just three PBMs control 80% of the prescription drug market and engage in harmful practices that drive up costs for patients and pharmacies, making it harder for independent pharmacies like Othello Station Pharmacy to provide care.
