WASHINGTON — The Association for Accessible Medicines and the Biosimilars Council today commented on a final rule published by the Department of Labor, “Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure.” According to the Department, the rule will improve transparency into fees and compensation received by pharmacy benefit managers and their affiliates. PBMs, starting in 2027, will be required to share data on compensation and fees with self-funded employers.
“This new rule brings meaningful transparency to the health care system by providing employers visibility into how PBMs charge for their services and allows for more informed decisions on behalf of their employees’ health care coverage,” John Murphy III said. “While this rule is an important step forward, more work needs to be done to reform opaque PBM practices and promote policies that will put generic and biosimilar medicines first. We are the only sector of the healthcare ecosystem that continues to drive down costs for patients through innovation and competition. When a generic or biosimilar is on the market, it should immediately be made available and prioritized for patients.”
A 2023 IQVIA study found that commercial plans, employers, and patients missed out on up to $6 billion in savings because of PBM price concession and fee schemes. The report highlights the strategy created by PBMs to protect $2 billion in profits by suppressing adoption of lower-cost versions of Humira and identifies several factors that ultimately limited biosimilar market share, including switching patients to another brand drug instead of the lower-cost biosimilar.
