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Radar On Market Access: PBM Trade Group Offers Alternative to Proposed Drug Rebate Changes

Posted by Leslie Small on Apr 16, 2019

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One day before executives from the country's largest PBMs testified on Capitol Hill about rising drug prices, the Pharmaceutical Care Management Association (PCMA), which lobbies on behalf of PBMs, submitted a comment letter telling the Trump administration in no uncertain terms that a proposed rule aiming to upend the prescription drug rebate system will do more harm than good, AIS Health reported.

The proposed rule, released Jan. 31, would remove safe-harbor protections under the federal anti-kickback statute for rebates paid by drug manufacturers to PBMs, Part D plans and Medicaid managed care organizations, and it would create a new safe-harbor protection for point-of-sale drug discounts.
 
PCMA argues that the proposed regulation would significantly increase premiums for all Part D beneficiaries, raise taxpayer costs for the program and destabilize Medicare Part D.

The trade group also takes issue with the proposal’s attempt to set up a system in which "a yet-to-be-determined third-party administers chargebacks within some newly created infrastructure." PCMA says such a process would be "long, costly, and complicated" and duplicate some of the work PBMs are already doing. Instead, it suggests that PBMs themselves should administer point-of-sale price concessions using the infrastructure that already exists.

According to Deb Devereaux, senior vice president of pharmacy at Gorman Health Group, the approach that PCMA is proposing makes sense.

"I don't see a way that the PBM would not be involved," she says.


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Topics: Industry Trends