Pharmacy coalition endorses PBM reform legislation

September 18, 2013

A coalition that includes pharmacy-advocacy groups has endorsed legislation it says will bring fairness and integrity to the Medicare Part D pharmacy program.

A coalition that includes pharmacy-advocacy groups has endorsed legislation it says will bring fairness and integrity to the Medicare Part D pharmacy program.

The PBM Reform Coalition sent a letter of support to backers of U.S. Senate legislation that addresses standards for basic pharmacy audits, further transparency of payment methodology to pharmacies, and recoupment of funds to Medicare by pharmacy benefit managers (PBMs). Members of the coalition include the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA), the Food Marketing Institute, GeriMed, H-E-B, MHA, Omnicare, PCAN, PharMerica, and Walgreens.

"Right now many PBMs are playing and winning by their own rules, at the expense of taxpayers, patients, and community pharmacies.  We commend the sponsors of S. 867 for recognizing that it is time for Congress to set some ground rules in the Medicare Part D program that are fair to everyone," said Dennis F. Wiesner, senior director for H-E-B, vice-president of the Texas State Board of Pharmacy, and PBM Reform Coalition spokesman. 

Wiesner said some PBMs engage in questionable business practices designed to maximize their own profits from the taxpayer-funded Medicare Part D program. Specifically, the PBM Reform Coalition cites improper disclosure of patient information, lack of transparency in reimbursement rates, and unfair audit practices. PBMs manage the drug benefits of more than 200 million Americans, including 25 million seniors on Medicare Part D.  

"Passage of S. 867 would put a stop to PBM practices that unfairly undermine community pharmacies and, indirectly, the patients in their care and the taxpayers paying for that care.  The PBM Reform Coalition welcomes this attempt to bring greater fairness and integrity to the Medicare Part D pharmacy program," Wiesner said.

The bill has been referred to the Senate Finance Committee.