PUTT Blog | 7 Days of PBM Reform and Resistance: A Not-So-Typical Week at PUTT

Are We Talking About the Same Middlemen? Following President Trump’s announcement today of “TrumpRx”, a new executive initiative to help lower patient drug costs, we thought  for a minute the Chief Executive might have gotten pharmacies confused with PBMs.  Currently there are not enough details to know exactly what TrumpRx is or how it would work, but we can all agree that patient safety cannot be compromised by removing access to trusted pharmacy professionals. Even if Trump lowers drug prices, PBMs can still exclude the lower cost drugs from their formularies in favor of higher cost drugs with rebate incentives. This includes Medicaid patients. True drug pricing reform begins by eliminating the perverse incentives PBMs achieve via manufacturer rebates, self-dealing plan designs, and PBM pharmacy ownership.   

There They Go Again: When news broke that PCMA was planning to propose changes to CMS aimed at “lowering drug prices” and “increased pharmacy reimbursement”, we worried the public - and the Trump Administration - might think genuine PBM reform was on the horizon.

But this is PCMA, and PCMA has a track record of suing whenever regulatory oversight is poised to interfere with its clients’ ability to generate their famously outsized profits. 

In 2021, PCMA sued to stop the Trump Administration’s "Rebate Rule" — a regulation that would have eliminated safe harbor protection for drug rebates paid by manufacturers to PBMs and insurers in Medicare Part D and Medicaid managed care. That rule would have delivered point-of-sale discounts directly to patients at the pharmacy counter, representing a major win for consumers.

The lawsuit's impact was significant. The Biden Administration, citing the ongoing litigation, delayed implementation of the Rebate Rule until 2032. That gives PBMs another decade to continue funneling drug rebates away from patients and into their own 'rebate aggregator' companies domestically and abroad. 

Pharmacies and patients should not subsidize multi-billion dollar PBMs. We’re using every available means of communication to reach legislators and those in DC with in-roads to CMS, urging our leaders not to fall for PCMA’s false promises, and asking leaders to ensure any changes PCMA proposes are grounded in sustainable policies that empower local pharmacies and actually put patients first. 

Help us remind the Trump Administration and CMS that PCMA helped stop first-of-its kind, historical Executive Office regulation that would have helped Americans afford their medications, and ask the Administration to keep its promise to eliminate middlemen profiteering. Contact us here for ideas, messaging and ways to reach out to DC. 

Pharmacists Get a Second Chance to Fight Back: With the Pharmacists Fight Back Act (PFBA) expected to be filed in October, last week Congressman Jake Auchincloss (D-MA) gave us our "marching orders" at the PUTT Virtual Summit for helping to get this mission-critical legislation across the finish line.

The first critical steps are clear: add cosponsors to the bill — both returning supporters from last year and new sponsors in this congressional session — and push Congress to send the bil to committee for "mark up” this session. Rep. Auchincloss also shared about the soon-to-be-filed Patients Before Monopoly Act - landmark legislation and a “shot across the bough” that would require PBMs to divest of their owned pharmacies if they are to continue in the pharmacy benefits management business. 

Additional details and campaign materials are coming soon. In the meantime, we’re calling on all PUTT members and friends to join our PFBA Campaign Group. For more information or to join, contact us here.  

Thank You for Breaking the Status Quo: This year’s Virtual Summit lived up to its name, with a record number of registrations and attendees participating throughout the 4-hour event. We extend our gratitude to everyone who joined us, and to our stellar guests and presenters, starting with Doug Hoey, CEO of NCPA; John Vinson, CEO of Arkansas Pharmacists Association and Senator Kim Hammer; Greg Reybold, Vice President of Healthcare Policy and General Counsel at APCI and Congressman Jake Auchincloss; PUTT Board Members Jeremy Counts and Brandi Chane; and our esteemed State Legislature Pharmacy Champions, Rep. Brett Barker (IA); Rep. Mike Echols (LA); Rep. Heather Rhyne (NC); and Del. Otto Wachsmann (VA). 

Registrants should have received a link to the video playback of the Summit as well as links to the presenters’ slides. We’ll be sending follow up emails from the Summit with answers to questions and updates. 

As we go to publication, a possible federal government shutdown is looming. PBM reform legislation is highly unlikely to be included in the Continuing Resolution but thanks to successive weeks of pharmacy professionals visits to Capitol Hill, Congress is more aware and motivated than ever to rein in PBM fraud, waste and abuse. 

We will continue to advocate for the rights of our independent pharmacy members and friends, and their patients, to ensure the future of community pharmacy is bright and flourishing.  

Yours in Advocacy,

Monique Whitney

Executive Director