DrugPrices

Prescription drug prices have risen sharply in recent years. Google Commons photo

U.S. Rep. Jake Auchincloss, D-Newton, has joined with Republican U.S. Rep. Ryan Mackenzie of Pennsylvania on a new bill aimed at pharmacy benefit managers—middlemen in the health insurance industry—in an attempt to curtail price-gouging and other industry abuses.

Auchincloss has long accused PBMs of “self-dealing,” which is when an insurance company requires the drugs with the biggest profit margin only be dispensed by that company’s affiliated pharmacies.

The two congressmen introduced the bill, PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, with Senators Roger Marshall, of Kansas; Tim Kaine, of Virginia; Maggie Hassan of New Hampshire; and Chuck Grassley of Iowa.

PBMs that provide drug benefits for employer health plans are not legally required to put employees’ interests first. Auchincloss maintains that this new bill would fix that by making them fiduciaries, which would put a legal obligation on them to practice in the best financial interest of customers.

“Instead of looking out for the best interests of employees, pharmacy benefit managers have been hitting them with prescription drug mark-ups, inconvenient pharmacy options, and wrongful denials,” said Congressman Auchincloss. “This legislation puts force of law behind the best interest standard. The PBMs either improve access and affordability, or they’ll pay out in lawsuits.”

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