[Congressional Record Volume 168, Number 105 (Tuesday, June 21, 2022)]
[Senate]
[Page S3021]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        PRESCRIPTION DRUG COSTS

  Mr. GRASSLEY. Mr. President, I am here today to visit with my 
colleagues about a group that we refer to as pharmacy benefit managers, 
but around Washington, the shorthand for that term is PBMs.
  Many Americans may not know about PBMs. They are very obscure in the 
whole pharmaceutical business. Yet the PBM market is nearly $500 
billion, and they are powerful in our pharmaceutical drug supply chain.
  It is our duty in Congress to understand, first, how PBMs operate; 
second, hold them accountable; and, third, work to lower prescription 
drug costs for the taxpayers and for the consumers.
  In 2018, I pressed the Federal Trade Commission to investigate PBMs. 
I saw the ongoing consolidation in the pharmaceutical supply chain and 
its impact on drug prices, driving those prices up. But I didn't wait 
for the FTC to act.
  I have pursued, one, bipartisan legislation; two, held hearings; and, 
three, conducted oversight. Most recently, Senator Cantwell and I have 
introduced the PBM Transparency Act. This bill prohibits PBMs from 
engaging in spread pricing. This is a situation where PBMs charge an 
insurer more than they charge the pharmacy and then they pocket the 
difference. Iowans call that gaming the system.
  Another practice we prohibit in our bill: clawbacks. In Medicare Part 
D, these are sometimes called retroactive direct and indirect 
remuneration fees--or DIR, for short.
  Iowa pharmacists have told me clawbacks are costing patients more in 
higher copays and also costing the local pharmacy. This practice is 
putting rural and independent pharmacists out of business. In addition, 
our bill will incentivize fair and transparent PBM practices, 
benefiting consumers and taxpayers.
  The bill has the support of community pharmacists, manufacturers, and 
patient advocacy organizations. Not surprisingly, this industry we call 
PBMs oppose the Cantwell-Grassley bill. They say my bill is ``anti-
competitive'' and, in their words, an ``expansion of power at the 
FTC.'' They also claim that their industry is already well-regulated. 
Nothing could be further from the truth.
  My bill establishes transparency and accountability. So good news: 
Tomorrow, the Commerce Committee will mark up the PBM Transparency Act. 
I don't happen to sit on this very important Commerce Committee, but I 
urge my colleagues to support this bill.
  Finally, I have never given up on passing the bipartisan Wyden-
Grassley bill, known as the Prescription Drug Pricing Reduction Act. 
Despite the Democrats having the majority for 18 months, we have not 
passed a prescription drug bill. So we still have high prescription 
drug prices.
  By now, I would assume they would be interested in advancing a 
bipartisan prescription drug bill. They can get 60-plus votes, save the 
taxpayers $95 billion and seniors, who are consumers, $72 billion--
rather than a partisan effort that doesn't have 60 votes here in the 
U.S. Senate.
  I want my colleagues to know I will work with anyone who wants to 
pass the bipartisan Wyden-Grassley bill.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Kaine). The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CORNYN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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