ATAP Calls on Congress to Stop PBM Abuses with Comprehensive Year-End Reform
Letter to Legislative Leaders Calls for Legislation to Protect Patients
The Alliance of Transparent and Affordable Prescriptions (ATAP), a coalition of more than 20 patient advocacy, medical professional, and healthcare organizations committed to addressing prescription drug affordability, is urging Congress to enact robust legislation to curb the abusive practices of Pharmacy Benefit Managers (PBMs) before the end of the year.
In a letter to legislative leaders, ATAP stresses that decisive reform measures are essential to address the escalating prescription drug costs that burden millions of Americans.
The letter, addressed to Speaker Johnson, Majority Leader Schumer, Republican Leader McConnell, and Minority Leader Jeffries, states, “As Congress considers year-end priorities, we urge you to advance policies that will stop the abusive practices of PBMs that increase drug costs for patients across the United States. We appreciate your consideration and look forward to working with Congress to address prescription drug costs and patient access to affordable treatments.”
"PBMs have operated with little accountability, profiting at the expense of patients who struggle to afford their medications," said Dr. Michael Schweitz, President of ATAP Action Network. "Congress has a critical opportunity to change this system by passing legislation that will increase transparency and ensure cost savings directly benefit patients, not the middlemen – and do it this year."
ATAP proposes two essential policy pillars that must be included in any year-end legislative package:
Delinking Drug Prices from PBM Income: ATAP advocates for legislation, such as the Modernizing and Ensuring PBM Accountability Act (S. 2973), that would prohibit PBMs from deriving income based on a medication’s list price. A provision included in S. 2973 would remove incentives for PBMs to favor higher-cost drugs and promote fair-market compensation, effectively addressing a key distortion in the current drug pricing system.
Passing Rebates Directly to Patients: ATAP supports mandatory pass-through of manufacturer rebates to patients at the pharmacy counter, ensuring that PBM-negotiated savings directly reduce out-of-pocket costs for those who need it most. The Better Mental Health Care, Lower- Cost Drugs, and Extenders Act of 2023 (S.3430) is one example of legislation that could deliver these savings to patients, countering the practice of rebates benefiting PBMs rather than patients.
The need for PBM reform has gained urgency following recent actions by the Federal Trade Commission (FTC) against major PBMs. In September, the FTC filed lawsuits against Optum Rx, Caremark, and Express Scripts, accusing them of practices that inflate costs for life-saving medications like insulin. The lawsuits underscore the necessity of legislative action to provide patients with lasting protections.
“While the FTC’s lawsuits are a crucial first step, only legislative reform can ensure that PBMs are held accountable for actions that have driven up drug prices," said Dr. Robert Levin, ATAP’s President. "This is Congress’ opportunity to deliver on policies that stop price manipulation and make medications more affordable for Americans."
ATAP is committed to working alongside Congress to advance policies that prioritize patient welfare and reform the prescription drug market to prevent PBMs from inflating costs for their own profit at the expense of patients.
About ATAP
ATAP was created in 2017 with a mission to address prescription drugs costs and patient access to affordable treatment by regulating PBM practices and reforming the drug industry through educational outreach and grassroots advocacy initiatives at both the state and federal levels. Driven by the reality that many patients struggle to afford their medications, the physician and patient advocacy organizations joined to shine a light on the abusive practices of PBMs.
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To schedule an interview with an ATAP spokesperson please contact Dan Rene at 202-329-8357 or dan@danrene.com.
Please visit http://www.atapadvocates.com