Summary
While legislative momentum for drug pricing reform has waned since the Build Back Better (BBB) Act stalled, regulators and legislators have continued to focus on pharmacy benefit managers (PBMs) and their role in the pharmaceutical supply chain. As this recent attention has been spread across different agencies and between the federal and state legislatures, the Wynne Health Group has compiled recent actions involving PBMs to provide the current landscape regarding PBM oversight.
Looking forward, we can expect significant PBM activity at the state level, as states continue to enact legislation to impose licensure requirements and prohibit certain actions. If a second attempt at reconciliation is pursued this year, the new package could feature similar PBM transparency provisions as the BBB Act, but such a proposal is unlikely to be a significant cost saver. Elsewhere, with new access to direct and indirect remuneration (DIR) data, we could also expect the Medicare Payment and Access Commission (MedPAC) to explore recommendations targeted at PBM practices this fall, as well as the Federal Trade Commission pursuing a PBM study as a result of their request for comments.