[Congressional Record Volume 161, Number 177 (Tuesday, December 8, 2015)]
[House]
[Page H9029]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PHARMACY BENEFIT MANAGERS
The SPEAKER pro tempore (Mr. Jolly). The Chair recognizes the
gentleman from Georgia (Mr. Collins) for 5 minutes.
Mr. COLLINS of Georgia. Mr. Speaker, I come here today, as I have on
many other occasions, to discuss an issue that is close to my heart,
but it is also close to every small community and every large community
across the country, and that is the plight of our community
pharmacists. Community pharmacists are struggling to survive each and
every day in light of the anticompetitive behavior of pharmacy benefit
managers, PBMs.
Let me state up front: I have no problem with a company doing
business. I have no problem with them playing in the bounds of what is
fair and what is legal, and PBMs have a role in the marketplace.
However, what we found out just in the last few weeks in the Judiciary
Committee in a hearing is there is still a lack of regulation,
enforcement, and transparency, and it is threatening the very existence
of our community pharmacists in which the PBMs are acting not as
competitors but, many times, as bullies.
To make matters even worse--and this is what was amazing to me--
community pharmacists cannot even speak out about the appalling
practices of the PBMs that they are forced to do business with because,
when they do, the repercussions are swift and severe. It has been
amazing to me to talk all across the country to community pharmacists
who simply want to talk about what is going on in their business model
in which they are put at a distinct disadvantage, and yet there are
many of them saying: I can't say anything publicly because I know I
will be reprimanded or my contract will be changed or my contract will
be withdrawn, and I will be out of business.
Mr. Speaker, that is just wrong. No matter what is said, we have seen
firsthand that in relation to State laws that have been in response to
this issue, the States have enacted transparency reform with generic
drug prices and reimbursement systems called the MAC transparency laws.
In fact, to date, 24 States have enacted such laws. The goals of
these laws is to increase transparency and provide structure around the
generic drug pricing and reimbursement system. But when community
pharmacists speak out in support of these reasonable reforms, the PBM
community has retaliated through business lawsuits against the State
and even discussing it in the contracts with community pharmacists
saying: Well, it would be better if we get these laws repealed.
There is just a problem here. When you have the ability to force your
competitors to be audited by you and to be controlled by you to where
there is no transparency, where there are issues of community
pharmacists simply barely able to survive, the PBMs are not
representing the best interests of consumers; the PBMs are representing
themselves. If they were truly acting in the best interest of
consumers, as they claim, they would not oppose virtually every single
transparency reform effort on the State and the Federal level. In fact,
it is really interesting. They come to Congress and say one thing to
Members, and then they turn around and behave however they wish in the
pharmacy marketplace without fear of enforcement or oversight.
As I said from this floor a few weeks ago, I will continue this fight
because they can't audit me. They can audit my community pharmacists,
and my community pharmacists are scared because they know their very
livelihood is being put out by those who would come with shiny objects
and savings that many times never materialize, but at the same time
funneling money to their own businesses.
Mr. Speaker, it is time to change, and it is time to change it now.
We must preserve pharmacy access for patients, especially those in
rural areas like north Georgia, and we must put an end to the bullying
that seems to be going on.
What is amazing is a PBM can make a mistake and say that a pharmacy
was not part of the new network, and when called on that, saying that
we are part of that new network, they say: Well, we will send out a
retraction when we get around to it. Pharmacists lose business based on
these kinds of letters, and, yet the PBMs say: Oh, well, we will get
around to it when we can.
That is why I am proposing H.R. 244, because community pharmacists
routinely incur losses of approximately $100 or more on prescriptions
because PBMs reimburse pharmacies well below their cost to acquire and
dispense generic prescription drugs, and they have skyrocketed in
price. The PBMs may wait weeks or months to update the reimbursement
benchmarks they use to compensate pharmacies while drug prices increase
virtually overnight. This situation jeopardizes pharmacists' ability to
continue to serve patients because it leaves community pharmacists with
unsustainable losses.
Mr. Speaker, I would urge you and other colleagues to cosponsor H.R.
244. This reasonable legislation would require PBMs to update their
maximum allowable cost benchmark every 7 days to better reflect market
costs and allow pharmacists to know the source by which PBMs set
reimbursements for their community pharmacist.
Many times we come to the floor fighting for businesses both large
and small. But this is a time in which we are coming and I am coming to
the floor fighting for community pharmacists who many times are the
main source of health care in a community. They are the ones that are
trusted. They are the ones that are needed. And it is time for this
body to stand up for them, against the anticompetitive tactics of PBMs
and the bullying behavior that has got to stop.
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