ATAP Sends a Letter to Congressman Schrader and Congressman Gianforte

ATAP sends a letter to Congressman Schrader and Congressman Gianforte calling for action on the issues resulting from Pharmacy benefit managers (PBMs) practices.

December 18, 2019
RE: H.R. 5304, PBM Transparency in Prescription Drug Costs Act Congressman Schrader and Congressman Gianforte:

The Alliance for Transparent and Affordable Prescriptions (ATAP) is a coalition of provider and patient groups who have joined together over our shared concern with the practices of pharmacy benefit managers. As patient and healthcare provider advocates, we strongly support H.R. 5304, the “PBM Transparency in Prescription Drug Costs Act,” which addresses the lack of transparency in the PBM industry, limits the predatory practice of spread pricing, and ensures that price concessions are passed through.

Pharmacy benefit managers (PBMs) were initially created to fulfill the administrative function of administering prescription drug benefits. In addition, PBMs were intended to control costs through negotiating rebates and discounts with pharmaceutical manufacturers and controlling utilization by beneficiaries. Unfortunately, PBMs have morphed beyond those original functions into mega-entities that deny patients access to needed medication and often fail to pass on the price concessions they obtain from manufacturers.

Your legislation takes critical steps to address some of the issues our patients are struggling with as a result of PBM practices. First, the legislation creates transparency with regard to formulary design and money flowing into the PBM from the manufacturer. Currently, this information is opaque, which makes meaningful reform difficult. Additionally, the legislation limits spread pricing, a much condemned practice by which the PBM charges a payer more than it reimburses the pharmacy for a product and keeps the difference. Finally, the legislation will ensure a pass-through of price concessions from the PBM to the issuer, bringing us one step closer to ensuring that patients can directly benefit from negotiations between manufacturers and PBMs.

In closing, we thank you for your leadership on this issue. Please do not hesitate to contact us if there is anything we can do to help advance this important legislation.

Sincerely,

American Association of Clinical Urologists American College of Rheumatology

Association of Women in Rheumatology California Rheumatology alliance
Coalition of State Rheumatology Organizations Florida Society of Rheumatology

Georgia Society of Rheumatology
Global Healthy Living Foundation
International Foundation for Autoimmune and Autoinflammatory Arthritis Kentuckiana Rheumatology Alliance
Lupus and Allied Diseases Association, Inc.
MidWest Rheumatology Association
National Infusion Center Association
National Organization of Rheumatology Managers
New York State Rheumatology Society
North Carolina Rheumatology Association
Ohio Association of Rheumatology
Rheumatology Alliance of Louisiana
Rheumatology Nurses Society
South Carolina Rheumatism Society
Tennessee Rheumatology Society
U.S. Pain Foundation
Virginia Society of Rheumatologists