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Lankford Applauds Finance Committee Action to Address Some Root Causes of High Rx Prices

CLICK HERE to watch Lankford’s opening remarks on YouTube.

CLICK HERE to watch Lankford’s opening remarks on Rumble.

CLICK HERE to watch Lankford’s markup remarks on YouTube.

CLICK HERE to watch Lankford’s markup remarks on Rumble.

WASHINGTON, DC – Senator James Lankford (R-OK) today participated in a Finance Committee Open Executive Session to Consider the Modernizing and Ensuring PBM Accountability (MEPA) Act and markup the bill. Several provisions in the bill come from bills Lankford has introduced that address the abusive practices of pharmacy benefit managers (PBM), the drug-price middlemen, which negatively impact pharmacies, particularly rural and independent pharmacies. Lankford continues to call out the ways PBMs drive up the cost of prescription drugs and decrease cost transparency for pharmacists and patients.

Last month, Lankford introduced two vitally important bills to tackle the biggest drivers of the high cost of prescription drugs for Medicare beneficiaries: the Ensuring Access to Lower-Cost Medicines for Seniors Act and the Prescription Drug Supply Chain Pricing Transparency Act. Lankford’s Prescription Drug Supply Chain Pricing Transparency Act was fully included in the final bill.

Lankford offered his Ensuring Access to Lower-Cost Medicines for Seniors Act as an amendment today and received confirmation from Finance Committee leadership that policies included in this bill will continue to be thoroughly examined as potential additions in the Committee’s ongoing work on PBM reform.

Two abusive practices PBMs utilize, which Lankford recently called out on the Senate floor, are direct and indirect remuneration (DIR) fees and the manipulation of a drug’s coverage and placement on a “tier” of coverage that determines patient access to a drug. This gaming between name-brand drugs and generics keeps prices high for patients at the pharmacy counter while simultaneously making PBMs more money.

At a recent Senate Finance Committee hearing, Lankford pressed the witnesses about practices PBMs use to limit access to lower-cost generic drugs, manipulating Medicare Part D health plans’ formulary tiers to usurp patients’, doctors’, and pharmacists’ expertise, sometimes forcing a patient to pay for a higher-cost brand-name drug even when a cheaper option is available.

Lankford also introduced the Protect Patient Access to Pharmacies Act to ensure all pharmacy price concessions, including fees imposed by PBMs, are assessed at the point of sale and that pharmacies will have proper access to performance metrics so they can continue serving Medicare patients. Part of this bill was included in the MEPA, but Lankford continues to push for strengthened language to ensure pharmacies are adequately reimbursed and their patients are fully protected.

Transcript of Opening Remarks

I am so grateful we’re having this hearing today. This has been an issue we’ve talked about for a long time; I’m grateful to finally be at this day. I have been ringing the bell on PBMs for years. We are almost four years to the day today from the last health care markup that this Committee actually held. At that markup, I brought a bill on PBMs dealing with greater access for seniors and lowering the cost for them. I’m bringing that back up again today. Unfortunately, from 2019 to now, CBO has not been able to do a score on it and so we’ll have some opportunity to be able to talk about that as well. But this is an issue that I’ve been talking about for a very long time, and I’m very grateful that we are all on board on this as many of us have talked about this for a very long time as well.

This is one of those issues that occasionally we get pressed on to say, ‘Are you opposed to free markets?’ I’m not opposed to free markets. I’m opposed to PBMs running my rural pharmacies out of business. That’s what I’m opposed to. And over and over again when I talk to rural pharmacies, they tell me their frustration of a PBM changing the rules mid-month, charging them more for their DIR fees than they actually received for the drug total. These are issues that we’ve got to be able to address. So, grateful that a number of the proposals that I’m on with many of you on both sides of the aisle are also on, deal with greater transparency, greater access to biosimilars, greater access to generics, greater opportunities for HHS to report to this Committee what’s going on, greater opportunities to be able to get from GAO some additional information that’s needed, but also this is the front door towards dealing with additional items that need to be here—and quite frankly need to be strengthened even in this bill.

If I go back to something that Senator Grassley said, we’ll get this shot to be able to do this. We need to make sure it’s the strongest we can possibly make it and so we don’t think we’ve actually solved the problem, if the problem is still yet to be solved. So, look forward to the conversation today.