White House Spotlight on Pharmacy Benefit Managers

The White House held a listening session on the pharmacy benefit manager industry, signaling the administration’s focus on reforms of the pharmaceutical industry. Attendees included Mark Cuban, HHS Secretary Xavier Becerra, Dared Price, owner of Oread Rx, a new PBM, and Sandra Clarke, COO of Blue Shield California which recently dropped its PBM and partnered with Cuban’s Cost Plus Drugs.

Why it matters: Participants discussed potential state and federal reforms intended to make the pharmaceutical industry more transparent. HR Policy has been supportive of reforms aimed at increasing transparency between PBMs and employers. 

The three largest PBMs were not invited to the session sparking criticism from the Pharmaceutical Care Management Association, which claimed the event “serves to promote only one model and one perspective.” FTC Commissioner, Lina Khan, was also in attendance. The FTC is currently undergoing an inquiry into the business practices of PBMs. 

President Biden hinted at additional reforms aimed at lowering prescription drug prices during his State of the Union address. These included expanding the list of drugs eligible for Medicare price negotiation to 50 a year, up from 20.

Outlook: Despite bipartisan support of reforms included in the Lower Costs, More Transparency Act which passed Congress and two Senate committees, the latest government funding bills do not include PBM reforms. This means any action will likely be pushed to a lame duck Congress in November.