SCPC Looks Forward to Working with CMS Administrator Seema Verma to Hold PBMs Accountable for Opaque, Controversial Drug Pricing Practices

By a News Reporter-Staff News Editor at Insurance Weekly News -- one of which is clearly abusive pricing and contractual protocols that PBMs unilaterally impose on LTC pharmacies," said Alan G. Rosenbloom, President and CEO of SCPC.

"PBMs are unscrupulously adding costs to consumers and federal programs, particularly Medicare Part D, and we are hopeful Ms. Verma's recent written responses to Questions for the Record from Senate Finance Committee members signal Ms. Verma's openness to all the drivers of escalating prescription drug costs and their impact on Medicare beneficiaries and Medicare expenditures," Rosenbloom continued. Part D pays for a significant majority of drugs dispensed to patients in LTC facilities and other senior care settings.

Rosenbloom said SCPC was pleased that Ms. Verma's responses to Questions for the Record from Senator Sherrod Brown (D-OH) demonstrate her willingness to evaluate PBM pricing and practices and their impact on beneficiaries and Medicare expenditures. In those responses, she noted that she would welcome the opportunity to work with pharmacies and other interested parties "to preserve seniors' access to drugs," and to resolve pending issues related to the 2014 "Proposed Guidance on Direct and Indirect Remuneration (DIR) and Pharmacy Price Concessions."

DIR fees refer to a variety of charges PBMs impose on pharmacies after the point-of-sale. PBMs may establish any fees they want and set any amounts they want, which in turn contributes to higher out-of-pocket costs to beneficiaries and to greater Medicare Part D expenditures.

Keywords for this news article include: Medicare, Health Policy, Senior Care Pharmacy Coalition.

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