Investigate the role of PBMs on personal spending – Endpoints News

Following the Federal Trade Commission’s decision last month not to investigate pharmaceutical intermediaries or drug benefit managers, Republican Iowa Senator Chuck Grassley sent a letter last week to the FTC Chairman, Lina Khan, urging the commission to find common ground and take a hard look at how the PBM industry affects out-of-pocket spending by patients.

Grassley’s appeal comes as Khan has urged fellow commissioners to press ahead with a “long overdue” investigation into PBMs because the commission has “a genuine moral imperative to act”. PBMs have long been criticized for driving up patient spending at the pharmacy counter and for using tactics to drive people away from community pharmacies to their chain pharmacies.

The top three PBMs – run by CVS/Caremark, OptumRx and ExpressScripts – control about 75% of the market, though how they operate has a lot to do with “little or no transparency” in their industry, Grassley writes. He also notes that this lack of transparency makes it “very difficult, if not impossible, to understand the flow of money in the prescription drug market and how PBMs determine prescription drug prices.”

Grassley previously introduced legislation that would require the FTC to investigate and report to Congress on PBM consolidation and anticompetitive behavior.

Khan noted at that February hearing that she had seen two major trends related to PBM — patients are paying more for drugs, including life-saving ones, and in some cases being forced to ration their drugs. The other trend is that small local and family pharmacies are disappearing at a high rate.

Grassley also urged the two FTC commissioners, Noah Phillips and Christine Wilson, who voted against the original study, to find common ground.

“Looking at the record of the FTC public hearing on February 17, there is broad support among all commissioners for conducting a 6(b) study into PBM business practices. A more targeted focus of study on the impact of PBMs on consumers and the direct costs of their prescription drugs appears to be an area of ​​agreement,” Grassley wrote.

Comments are closed.