U.S. Rep. Jake Auchincloss, D-MA, is working with some seemingly unlikely allies in his fight against high prescription drug prices.
Auchincloss and U.S. Sen. Elizabeth Warren, D-MA, recently introduced a bill—the Patients Before Monopolies Act—along with U.S. Rep. Diana Harshbarger, a Republican from Tennessee, and Republican U.S. Sen. Josh Hawley from Missouri, banning companies from jointly owning pharmacies and employing pharmacy benefit managers.
“The PBM industry is rife with self-dealing that raises costs for patients and bankrupts independent pharmacists. No PBM should be allowed to own pharmacies, because it poses an unacceptable conflict of interest when it then sets reimbursement rates for its own versus external pharmacies. Independent pharmacies deserve fair play,” Auchincloss said.
This is the second bill Auchincloss and Harshbarger have worked on together relating to pharmacy benefit managers (middlemen in the health insurance industry). Auchincloss has accused companies of “self-dealing” and “steering,” requiring drugs with the biggest profit margins be exclusively dispersed to the customer via that company’s affiliated pharmacies.
If the Patients Before Monopolies Act makes it into law, parent companies of insurers and pharmacy benefit managers (PBMs) will have three years to divest any pharmacy businesses they may own. And the Federal Trade Commission, Department of Health and Human Services, and Department of Justice would be in charge of monitoring companies for violations, and the FTC would be able to redistribute a violating company’s revenues to communities harmed by overcharges associated with PBMs.
Health care conglomerates have waded increasingly into the pharmacy industry, and now most major health insurance companies own pharmacy chains and have pharmacy benefit managers, creating what critics like Auchincloss call a conflict of interest.
Harshbarger is a former pharmacist and said she’s seen PBMs take advantage of the health care system to increase profits for their companies at the expense of customers.
“As a life-long pharmacist, I know first-hand how unchecked PBM consolidation and vertical integration have allowed these shadowy middlemen to self-deal and manipulate the system in ways that are driving up drug costs, limiting patient choices, and putting the financial screws to independent community pharmacies,” Harshbarger said. “I’m a proud conservative Republican, but we have antitrust laws for a reason. That’s why I’m joining my colleagues in introducing the bipartisan Patients Before Monopolies Act, which will protect consumers and taxpayers, and ensure fair competition by breaking-up these anticompetitive, conflict-of-interest arrangements. Federal regulators should never have let this excessive concentration of our healthcare industry happen in the first place, and so it’s up to Congress to get the job done.”