A recent NAPA article notes key priorities of the Senate Committee on Health, Education, Labor, and Pensions (HELP), now chaired by Senator Bill Cassidy (R-LA). Cassidy and ranking member Bernie Sanders (I-VT) both signaled a desire to change laws impacting pharmacy benefit managers.
Drug manufacturer rebates are often a "black box" for employers that sponsor group health plans, and the insurer often keeps most or all of the rebates (in the case of fully insured plans). In light of bipartisan support, employers should monitor progress in Congress for possible help with escalating prescription drug costs. Even without law changes, employers should proactively raise issues regarding manufacturer drug rebates with their health plan consultants, brokers, and insurers.
Cassidy agreed that PBM reform should be a committee priority and said they should ensure "100% of drug discounts are passed to the patient," a reference to the Pharmacy Benefit Manager Reform Act, which passed out of the committee last Congress and would require PBMs to return manufacturer rebates to the payer in full, among other requirements.
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