Webinar: Frier Levitt’s Harini Bupathi delivers a mid-year PBM audit update
Bupathi offers timely insights on the evolving pharmacy-PBM dynamic.
Bupathi offers timely insights on the evolving pharmacy-PBM dynamic.
National and state pharmacy groups emphasize the need for state control to regulate PBMs and protect local pharmacies, patients, and health plans.
The Swiss drugmaker is in active discussions with the U.S. government regarding a plan that could eliminate middlemen, such as pharmacy benefit managers (PBMs).
The policy would have prevented PBMs from having their compensation linked to the list prices of medications.
The legislation includes banning spread pricing and requiring PBMs to pass 100% of manufacturer rebates to health plans or patients.
The removed provisions—a ban on PBM spread pricing in Medicaid managed care and a reimbursement rate floor—were included in both the House bill and the Senate Finance Committee's version.
The legislation would require full transparency from PBMs, including the complete pass-through of ingredient costs and pharmacy dispensing fees.
PCMA argues the law is unconstitutional and may disrupt access to mail-order and specialty medications.
The lawsuits argue that the law, scheduled to take effect in 2026, is unconstitutional under multiple provisions.
CVS Health had lobbied against the law, running TV ads and calling on the governor to veto the bill. The company says the law will harm patients and the economy.
NACDS emphasizes the importance of enacting the sound reforms that are ready to go and broadly supported in Congress.
“By whatever means, the consensus PBM reforms are long overdue and need to be enacted now. The negative impacts of inaction are mounting for Americans and for their pharmacies.”