Last week, Sen. Tommy Tuberville, R-Alabama, authored an op-ed in the Washington Times on helping patients and independent pharmacies by bringing greater transparency to the practices of large pharmacy benefit managers.
“Our great country was founded on hard work and competition,” Tuberville wrote. “That sense of grit is the main principle in our free-market economy where consumers have choice, because competition breeds choice, better quality, and better prices for customers.”
“But not everywhere. Unfortunately, most Americans don’t have that choice when it comes to prescription drugs,” Tuberville wrote. “The prices of life-saving medications keep going up. According to the AARP, prescription drug prices are rising even faster than inflation. Americans’ spending on medicines jumped 200% between 2000 and 2020. It’s time the American people start to question why this is happening.”
“Folks may not be familiar with Pharmacy Benefit Managers, or PBMs, but they live with the effects of PBMs almost every time they go to fill a prescription and have to dig deep in their wallet to pay for it,” Tuberville wrote. “PBMs are essentially middlemen in the prescription drug supply chain. They negotiate with drug manufacturers to secure discounts on medications by adding those medications to insurance plans’ formularies. They contract with pharmacies and insurance plans to process and pay prescription drug claims.”
“PBMs claim they help patients by negotiating lower prices from drug manufacturers. But the fact is PBMs rarely, if ever, pass those savings on to patients,” Tuberville wrote. “More often, PBMs use their bargaining power to bring the cost of a drug down but pocket the difference for themselves. The PBMs get richer, while patients get squeezed.”
PBMs are being widely criticized for limiting which pharmacies get preferred prices, locking out small neighborhood pharmacies, subsidizing mail-order pharmacies, limiting the drugs that doctors can prescribe, and forcing small pharmacies out of business. Tuberville cited that between 2010 and 2018, 1,300 — roughly 6 percent — of independent pharmacies went out of business.
Tuberville warned that rural Alabama is particularly vulnerable to pharmacy benefit manager abuse because wide swaths of the rural part of the state are served primarily by small independent pharmacies. The Alabama Legislature passed pharmacy benefit manager reform legislation during the 2021 Legislative Session.
Tuberville praised the Legislature for passing this legislation.
Tuberville is a cosponsor of the Prescription Pricing for the People Act. The bipartisan legislation would require the Federal Trade Commission to study anticompetitive practices by PBMs within the pharmaceutical supply chain.
Sens. Chuck Grassley, R-Iowa, and Maria Cantwell, D-Washington, reintroduced the Prescription Pricing for the People Act requiring the FTC to examine the effects of consolidation on pricing and other potentially abusive behavior within the PBM industry, and provide policy recommendations to Congress to improve competition and protect consumers.
“PBMs play a significant role in determining how much patients and the government pay for prescriptions,” Grassley said. “Much of their business model is cloaked in secrecy, and the industry has experienced significant consolidation in recent years. Our bill will provide Congress with a better understanding of the PBM industry, so any future legislation can better protect patients and safeguard competition.”
“Greater transparency and oversight are needed to increase competition and make sure patients get a fair deal on the medications they need. People’s lives depend on access to affordable medicine,” said Cantwell.
Tuberville represents Alabama in the U.S. Senate and is a member of the Senate Armed Services, Agriculture, Veterans’ Affairs, and HELP Committees. Tuberville is serving in the first year of his first term in the U.S. Senate following a successful college football coaching career, most notably at Auburn University. Tuberville unseated incumbent Sen. Doug Jones in 2020.