ATAP Press Release: PCMA v. WEHBI – A Victory for State Regulation of Pharmacy Benefit Manager Industry

FOR IMMEDIATE RELEASE

November 19, 2021

CONTACT

Dan Rene of kglobal 202-329-8357 or daniel.rene@kglobal.com

PCMA v. WEHBI – A VICTORY FOR STATE REGULATION OF PHARMACY BENEFIT MANAGER INDUSTRY

Patient Advocacy Organizations Unite to Encourage Elimination of Abusive PBM Practices Through Effective Regulation

[Bismarck, ND] [November 19, 2021] – Today the Alliance for Transparent and Affordable Prescriptions (ATAP) a coalition of physician and patient advocacy organizations dedicated to exposing the effect the pharmacy benefit manager (PBM) industry has on rising prescription drug costs applauded the ruling by the 8th U.S. Circuit Court of Appeals in Pharmaceutical Care Management Association v. Wehbi. 

“This is another big legal win for state PBM regulation,” stated ATAP President Dr. Robert Levin. “We see first-hand how the PBM industry drives up costs and interferes with medical care. Doctors, patients, legislators, and regulators are all saying, ‘enough is enough’ and fighting back. Now, the Courts have once again weighed in on supporting state decision to regulate this rogue industry.”

In July, ATAP joined with the Community Oncology Alliance (COA) and American Pharmacies in filing an amicus brief in the case challenging a North Dakota law designed to regulate abusive practices by the PBM industry.

The brief prepared by Daniel Geyser of Alexander, Dubose & Jefferson, LLP, may be found here. ATAP, COA, and American Pharmacies argue in the brief that: 

“…PBMs engage in harmful practices that impair optimal patient care, distort the free market, and impose serious costs on every major stakeholder in the healthcare industry. States are ideally positioned to attack PBM misconduct; the regulation of healthcare is a traditional state function, and States routinely address market inefficiency and abuse, just as North Dakota did…”

Following a ruling by the United States Supreme Court in Rutledge v. Pharmaceutical Care Management Association (where ATAP also filed an amicus brief), many states have begun to explore regulating the PBM industry to lower costs and increase access to therapies. That case resulted in a unanimous 8-0 decision where the Justices agreed that states have the right to impose regulations on PBMs. Despite setbacks in legislatures and the courts, the PBM industry continues to raise challenges to state regulation of their practices in its efforts to avoid accountability.

“We are thrilled the Courts were able to see through the previously hidden profit motives of the PBM industry,” said Dr. Angus Worthing of the American College of Rheumatology, an ATAP member organization. “With each new state law combined with other actions at the federal level, patients, physicians, and policymakers now have the power to effect meaningful change.”

ATAP has been an active advocate for patients in many federal and state battles to amplify the voices of patients and physicians – especially as it relates to exposing PBM abuses and their impact on patients’ access to therapies (medications) needed in their treatment.

“The Court saw, like we all do, that patients are suffering under a system preventing them from obtaining medicine they need – at prices they can afford,” said Dr. Michael Schweitz of the Florida Society of Rheumatology, an ATAP member organization. “The PBM industry profits significantly off rebates and other schemes while interrupting the provider-patient relationship. It is time to do what is right and allow policymakers to stand up and do the right thing and regulate this industry.”

“The profit motivations from the PBM industry impact real people in dangerous ways,” Dr. Levin continued. “ATAP members are on the front lines of medical care. We see the struggles and confusion that patients experience by this middleman industry. They deserve better – they deserve the truth – not dangerous interference with their medical care from policies motivated only by profit.”

ATAP is working in many states to force the PBM industry to disclose rebate data and encourage transparency and reporting requirements for all entities involved in the prescription drug supply chain – PBMs, insurers, and manufacturers. The ruling, which ATAP will review, also includes language related to the parameters of federal preemption of state legislation and regulation affecting Medicare Part D plans. 

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For more information or to schedule an interview with an ATAP spokesperson, contact Dan Rene at 202-329-8357. 

Please visit http://www.atapadvocates.com