NASP Commends Senate Finance Chairman for Combating PBM Unfair Practices

Continues to call for immediate federal action to support patient choice in pharmacy and protect specialty pharmaceutical companies

Washington, DC, June 26, 2024 (GLOBE NEWSWIRE) — The National Association of Specialty Pharmacy (NASP) thanks U.S. Senate Finance Committee Chairman Ron Wyden (D-OR) for proactively engaging the Biden administration to combat illegal and egregious practices that are limiting patients’ access to the specialty pharmacy of their choice and specialty pharmacy businesses across the United States

On June 24, Chairman Wyden sent a letter to the Centers for Medicare and Medicaid Services (CMS), asking the agency to “immediately intensify monitoring and enforcement of Medicare Part D program requirements for PBMs that protect pharmacies from unfair contractual practices”. Denouncing PBMs that do not adhere to Medicare Part D rules issued by CMS affecting pharmacies’ DIR fees and undermining payments to pharmacies to limit patient network access, the President singled out the aggressive actions of PBMs that are both contrary to existing law and in violation. rules established by the Biden administration and which took effect as recently as January 2024.

The President outlines the immediate actions CMS must take (in summary):

• Enforce “any pharmacy voluntary” requirements by ensuring that PBMs reimburse pharmacies a minimum of the cost of acquiring and dispensing covered prescription drugs.

• Apply, for example through an audit, the pharmacy price concessions provision included in the 2023 Medicare Part D final rule that requires all pharmacy price concessions to be applied to prices negotiated at the point of sale under Part D.

• Implement standardized pharmacy performance measures.

• Review formal or informal complaints regarding PBM Part D contracting practices received over the past 18 months to determine whether the number of complaints is higher than in previous years.

• Respond to this letter indicating the number of formal or informal complaints received regarding PBM contracting practices during the past 18 months, a description of the type of complaints received, and the action taken on them.

“We thank Chairman Wyden for his continued leadership and call on CMS to use its existing authority to enforce the law and its own regulations without delay and while Congress continues to work to pass broader reforms to protect pharmacies specialists and their patients,” said Sheila Arquette, R.Ph., President and CEO of NASP. “NASP remains grateful for the bipartisan work in the Senate and House to establish broader pharmaceutical protections as part of legislative PBM reform efforts. These efforts by CMS and Congress must be accomplished this year. Pharmacies and their patients with chronic, life-altering and sometimes life-threatening illnesses have waited long enough!

# # #

The story continues

NASP represents all players in the specialty pharmaceutical industry. Specialty pharmacies serve patients with complex health conditions such as cancer, rheumatoid arthritis, multiple sclerosis, cystic fibrosis, hemophilia, organ transplants and rare diseases. Specialty pharmacies are accredited by a nationally recognized, independent, third-party accrediting organization, ensuring consistent quality of comprehensive medication and disease management and clinical patient care services.

CONTACT: Sheila M. Arquette, RPh National Association of Specialty Pharmacy (NASP) (703) 842-0122 [email protected]