Topics: Research and Development, Health Insurance, Pharmacy Benefit Managers, Government Price Setting
From accessing medicines to intellectual property to drug safety, PhRMA is devoted to advancing public policies that support innovative medical research, improve treatments and yield real results.
ICYMI: PhRMA President and CEO Stephen J. Ubl discusses patient affordability.
PhRMA president and CEO Stephen J. Ubl spoke recently at The Hill’s event, “Pathways to Patient Affordability.” He spotlighted patients’ affordability challenges, the unintended consequences we’re already seeing from the government price setting provisions in the Inflation Reduction Act (IRA) and how policymakers can address harmful pharmacy benefit manager (PBM) practices.
On the IRA, Ubl noted that the legislation does “a poor job of balancing continued incentives for innovation without lower costs for patients at the pharmacy counter.”
He went on to note the law failed to address the role of other actors in the health care system, like insurance companies and pharmacy benefit managers (PBMs), that ultimately determine what patients pay out of pocket for medicines.
“Three PBMs now control 80% of the market and they’re vertically integrated with health plans,” Ubl said. “They do play a role in restraining costs but there is very little evidence the fruits of their efforts are actually translating into lower costs for consumers.”
To help lower costs for people at the pharmacy, the discussion touched on several policy ideas, including protecting copay assistance that many patients rely on, making sure no patient has to pay more for their medicine than their health plan pays and demanding more accountability from PBMs.
The main message? Let’s try to address the parts of the IRA that are already harming biopharmaceutical innovation and make sure patients are not paying more for their medicines than their health plans or PBMs. Or as Ubl commented, “The system is broken. We have a system today that’s set up for patient pushers at the expense of patients, and we need to fix it.
Learn more here: PhRMA.org/Middlemen
Topics: Research and Development, Health Insurance, Pharmacy Benefit Managers, Government Price Setting
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