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Pharmacy Benefit Manager (PBM) execs testify before US Senate

Published on 10/04/19 at 09:42am

Executives representing pharmacy benefit managers (PBMs) appeared before the US Senate Finance Committee on Tuesday as they testified on the rising prices of prescription drugs.

In contrast to pharmaceutical company executives, who appeared before the senate in February 2019, the PBM execs blamed pharma for rising prices.

Pharma execs had in February pointed towards insurers and PBMs in suggesting the middlemen were responsible for rising prescription drugs prices in the United States.

Executives from CVS Health, Prime Therapeutics, Humana, UnitedHealth Group's OptumRx unit and Express Scripts parent Cigna appeared before the Finance Committee.

In pressing the PBM executives, Senator Ron Wyden said: “bottom line, PBMs are middlemen who strike deals with drugmakers in secret. In my experience that kind of negotiation rarely results in an act of charity for consumers.”

However William Fleming president of healthcare services at Humana, argued that: “a major factor contributing to the increase in drug spending is the list price of prescription drugs.”

Fleming pointed out that “drug manufacturers alone set the list price of prescription drugs” as he suggested that pharma firms “raise list prices to boost their revenue.” Fleming noted that just 255 of the drugs covered by Medicare (7%) had rebates in 2019.

Nevertheless Senator Wyden said: “PBMs are paying one set price to pharmacies for a particular drug, but they're turning around and charging Medicaid and other healthcare payers far more for that same prescription.”

Louis Goss

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