August 16, 2023
Recently, the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) passed bipartisan legislation to regulate and reform pharmacy benefit manager (PBM) practices. The legislation – S. 1339, the Pharmacy Benefit Manager Reform Act – is a bipartisan package authored by Chairman Bernie Sanders (I-VA) and Ranking Member Bill Cassidy, M.D. (R-LA). Generally, the bill would require PBMs to pass on all of the rebates they receive from drug manufacturers to employers and policy holders as well as ban spread pricing.
The committee adopted several amendments to the bill including a mandate for increased transparency, a study of PBMs to be conducted by the U.S. Department of Labor, and a requirement for PBMs to disclose certain spending information.
Two additional amendments were adopted that are a priority for the California Medical Association (CMA) and the American Medical Association (AMA). One amendment, offered by Senators Murkowski (R-AK), Hassan (D-NH) and Marshall (R-KS), would include the Safe Step Act in the larger bill – which allows for exceptions from medication step-therapy protocols. CMA and AMA have strongly supported the Safe Step Act. The second amendment from Senators Markey (D-MA), Braun (R-IN) and Marshall (R-KS) would require the Comptroller General of the United States to conduct a study on actions that may be taken to ensure appropriate access and affordability of naloxone for individuals seeking to purchase it over the counter.
The bill awaits consideration on the Senate floor.