Lawmakers Crackdown on Pharmacy Benefit Managers: The Kiplinger Letter
A crackdown on pharmacy benefit managers on drug costs might help Congress forget their differences.
To help you understand what's happening in health legislation and what we expect to happen in the future, our highly experienced Kiplinger Letter team will keep you abreast of the latest developments and forecasts (Get a free issue of The Kiplinger Letter or subscribe). You'll get all the latest news first by subscribing, but we will publish many (but not all) of the forecasts a few days afterward online. Here’s the latest…
At least one issue may overcome Congress’s current political dysfunction, a crackdown on pharmacy benefit managers (PBMs). In the House, lawmakers have already consolidated several related measures into a single piece of legislation, which will be among the first to receive a floor vote once the chamber acts on a plan to keep the government funded.
In the Senate, Majority Leader Chuck Schumer (D-NY) is expected to include the three major PBM-related bills that have emerged from committee in a broader healthcare package that is still to be worked out.
All the legislation includes transparency measures requiring PBMs to reveal how much they pay for various drugs, how much money they keep for themselves, and what costs/savings are passed along to insurers and patients. Greater oversight will likely help plan sponsors make better-informed decisions about contracts, leading to more competition between pharmacy benefit managers and lowering prescription drug costs overall.
Sign up for Kiplinger’s Free E-Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.
Profit and prosper with the best of expert advice - straight to your e-mail.
The legislation would also require the Government Accountability Office (GAO) to submit a report on the practices of pharmacy networks of group health plans, including networks that have pharmacies under common ownership with group health plans.
New restrictions on spread pricing are also certain, at this point. Spread pricing is when PBMs charge insurers more for a drug than they paid for it and keep the “spread” as profit. If they can’t stop passage, look for PBMs to lobby for looser requirements.
This forecast first appeared in The Kiplinger Letter, which has been running since 1923 and is a collection of concise weekly forecasts on business and economic trends, as well as what to expect from Washington, to help you understand what’s coming up to make the most of your investments and your money. Subscribe to The Kiplinger Letter.
Related Content
To continue reading this article
please register for free
This is different from signing in to your print subscription
Why am I seeing this? Find out more here
-
Earn Delta SkyMiles Worth Up to $1,800 with an AMEX Business Card
Delta SkyMiles and American Express offer 150,000 on business credit card for new cardholders.
By Ellen Kennedy Published
-
Stock Market Today: Markets Soar Amid Strong Earnings for Big Tech
Equities ended the week on an up note thanks to some of the market's biggest names.
By Dan Burrows Published
-
AI to Power the Next Generation of Robots
The Kiplinger Letter There's increasing buzz that the tech behind ChatGPT will make future industrial and humanoid robots far more capable.
By John Miley Published
-
The Robots Are Coming... But Not For a While
The Kiplinger Letter There’s excitement in the tech sector over the potential of humanoid robots, but widespread adoption is likely to be years away.
By John Miley Published
-
Farmers Face Another Tough Year As Costs Continue to Climb: The Kiplinger Letter
The Kiplinger Letter Farm income is expected to decline for a second year, while costs continue to up-end farm profitability.
By Matthew Housiaux Published
-
India's Semiconductor Sector Eyes Expansion Amid AI Chip Boom: The Kiplinger Letter
The Kiplinger Letter As Wall Street’s love affair with chip firms continues, a recent report highlights India’s plans to expand its semiconductor industry.
By John Miley Published
-
H-1B Work Visa Rules Get a Revamp
The Kiplinger Letter H-1B visas allow employers to hire high-skilled foreign workers. Regulators have finalized new rules for this visa program following last fall's proposal.
By Matthew Housiaux Published
-
Woes Continue for Banking Sector: The Kiplinger Letter
The Kiplinger Letter Regional bank stocks were hammered recently after news of New York Community Bank’s big fourth-quarter loss.
By Rodrigo Sermeño Published
-
Are College Athletes Employees of Their Schools?: The Kiplinger Letter
The Kiplinger Letter A recent ruling has ramifications for labor relations and the unionization of student athletes.
By Sean Lengell Published
-
Salton Sea Clean Energy and Lithium Project Gets Approval: The Kiplinger Letter
The Kiplinger Letter California's Salton Sea is due to see the construction of a new lithium extraction and geothermal clean energy power plant.
By Matthew Housiaux Published