WASHINGTON — U.S. Sen. John Thune (R-S.D.) today introduced the Strengthening Pharmacy Access for Seniors Act, bipartisan legislation that would increase transparency measures on pharmacy benefit managers (PBMs) and provide seniors with additional options to fill their prescriptions. The bill would specifically require PBMs to reveal the criteria used to classify drugs that are dispensed by certain pharmacies and prevent PBMs from steering patients to certain pharmacies that limit patients’ options.
“In order to truly determine the impact of PBMs’ practices on patients and the drug supply chain, transparency measures must improve,” said Thune. “This bipartisan legislation would shed light on the practices that occur in the prescription drug supply chain and ensure patients have choice in where they get their medicine.”
“We are extremely grateful to Senator Thune for introducing this bill to amend title XVIII of the Social Security Act to assure pharmacy access and choice for Medicare beneficiaries,” Amanda Bacon, executive director of the South Dakota Pharmacists Association. “This legislation has real impact here in South Dakota, where this practice is becoming a more prevalent problem. It often disrupts patient care, by steering patients away from their preferred pharmacy – and the pharmacists who have cared for them for years. In our rural state, this can even mean a patient now has to travel hundreds of miles, or rely on mail service for essential medications.”
“As PBMs have continued to consolidate and vertically integrate, they increasingly limit patient choice by declaring pricey medications as ‘specialty’ to steer patients to a PBM affiliated specialty pharmacy,” said Anne Cassity, senior vice president of government affairs at the National Community Pharmacists Association (NCPA). “Many of these so-called specialty drugs can and should be dispensed by independent community pharmacies directly to patients, instead of forcing seniors to rely on PBM-owned mail-order pharmacies. NCPA applauds Senator Thune and his colleagues for their leadership to tackle this anticompetitive practice that limits patient access to the pharmacy of their choice.”
The legislation is cosponsored by U.S. Sens. Sherrod Brown (D-Ohio), John Barrasso (R-Wyo.), and Debbie Stabenow (D-Mich.).
PBMs are third-party administrators in the prescription drug supply chain that are hired by health insurance plans to negotiate for rebates and other price concessions, decide which drugs go on formularies, and establish pharmacy networks.