Joco Today

U.S. Senators Roger Marshall of Kansas and Peter Welch of Vermont have introduced the Protecting Pharmacies in Medicaid Act, a bipartisan effort aimed at curbing abusive pricing practices by pharmacy benefit managers (PBMs). The legislation targets 'spread pricing,' a tactic where PBMs charge payers like Medicaid more than what they reimburse pharmacies for medications, pocketing the difference as profit. This practice has been criticized for inflating costs and undermining struggling pharmacies.

The bill is expected to save Medicaid an estimated $2 billion over ten years. Senator Marshall stated, “Pharmaceutical industry middlemen use a variety of tricks to line their own pockets at the expense of small, independent pharmacies and senior citizens.” He emphasized that prohibiting spread pricing would reduce prescription drug costs for Medicaid enrollees while supporting local pharmacies.

Senator Welch highlighted the impact on rural communities: “Pharmacies are essential to the care and wellbeing of our rural communities. But spread pricing by pharmacy benefit managers is making it harder than ever for community pharmacies to stay in business.” He expressed gratitude for the partnership with Senators Marshall, Warner, and Cassidy in introducing this legislation.

Senators Mark Warner from Virginia and Bill Cassidy from Louisiana have joined Marshall and Welch in this legislative initiative. Senator Warner commented on the necessity of the act: “Independent pharmacies deliver critical health care... Unfortunately, for too long, PBMs have engaged in shady tactics to line their own pockets.”

The Protecting Pharmacies in Medicaid Act has received endorsements from several associations including the Food Industry Association (FMI), National Community Pharmacist Association, and National Association of Chain Drug Stores. Steven C. Anderson, President and CEO of NACDS, urged swift congressional action: “Every day that PBM reform is delayed is another day that Americans pay inflated drug prices.”

B. Douglas Hoey, CEO of the National Community Pharmacists Association, noted past challenges in passing similar reforms but expressed gratitude for renewed efforts by Senators Welch, Marshall, Warner, and Cassidy: “These policies nearly made it through Congress at the end of last year... [the bill] not only promotes transparency and prohibits spread pricing but it makes sure pharmacies are paid fairly.”