Reps. Auchincloss, Comer, and Harshbarger Introduce the Bipartisan Pharmacists Fight Back Act
The Pharmacists Fight Back Act Cracks Down on Predatory Drug Pricing
WASHINGTON, D.C. – Today, U.S. Representatives Jake Auchincloss (D, MA-04), Diana Harshbarger (R, TN-01), and House Committee on Oversight and Government Reform Chairman James Comer (R, KY-01) introduced the Pharmacists Fight Back Act to tackle the manipulative practices of Pharmacy Benefit Managers (PBMs) – the middlemen of drug pricing. PBMs are directly responsible for driving up drug costs by thousands of dollars, gouging community pharmacists, and limiting patient choice in federal health care plans. This bipartisan legislation is the most comprehensive PBM reform in federal health plans introduced this Congress.
Patients, community pharmacies, and taxpayers have been forced to shoulder the burden of rising drug prices at the hands of PBMs. The lack of PBM accountability has inflated drug costs for families at the pharmacy counter and driven the closures of independent and community-based pharmacies. On average, one independent pharmacy closes every day in the US.
The Pharmacists Fight Back Act prohibits PBMs from engaging in predatory behaviors. The bill implements a transparent pharmacy reimbursement model using market-based pricing benchmarked to the National Average Drug Acquisition Cost (NADAC). It also removes the ability of PBMs to limit the network of pharmacies patients may choose to use and protects community pharmacists by prohibiting PBMs from steering patients to PBM-affiliated pharmacies. It enforces stricter penalties and more stringent oversight of PBMs working with federal health plans.
Please find both versions of the Pharmacists Fight Back Act under their respective jurisdictions under the House Committee on Energy & Commerce and the House Oversight Committee.
Please find the full press conference here, including remarks from Reps. Jake Auchincloss (MA-04), James Comer (KY-01), Diana Harshbarger (TN-01), Buddy Carter (GA-01), Sanford Bishop Jr. (GA-02), and Rashida Tlaib (MI-12).
“Americans want lower prices and a fair shot for small businesses. This bill delivers both. With support from the most progressive to the most conservative Members, Pharmacists Fight Back will lower prescription prices and put independent pharmacists on the level playing field they deserve,” said Rep. Auchincloss.
“Rarely does a day go by without hearing from my constituents in Kentucky who are struggling under the weight of soaring prescription drug costs. The questions I hear time and again are: Why is this happening? And who is benefiting? My response is the same each time, it’s the PBMs—the pharmacy benefit managers—who sit in the middle of nearly every prescription transaction,” said Chairman Comer. “PBMs have abused their position as middlemen to line their own pockets by retaining rebates and fees, undermine our community pharmacists and pass along costs to patients at the pharmacy counter. Congress has a responsibility to act and that's why I am proud to support the bipartisan Pharmacists Fight Back Act. This legislation takes meaningful steps to protect patients and our community pharmacists, ensuring they can access and provide affordable, life-saving medications to Americans without PBM interference. I look forward to working with Rep. Auchincloss, Rep. Harshbarger, and our local pharmacists to get this legislation to the President’s desk.”
“Patients and community pharmacists are being hurt by a system that PBMs have distorted for years which drives up out-of-pocket costs and forces local pharmacies out of business,” said Congresswoman Harshbarger. “The Pharmacists Fight Back Act introduces the transparency and fairness needed to stop PBM abuses and protect patient choice. This bill is about putting patients over profits and restoring a system that works for everyone.”
“PBMs, acting as government contractors in federal healthcare programs, are exploiting their position by under-reimbursing independent pharmacies. They are also steering patients towards and over-reimbursing PBM-affiliated pharmacies and denying patients the benefit of drug maker rebates at the pharmacy counter,” said Greg Reybold, Vice President of Healthcare Policy & General Counsel at the American Pharmacy Cooperative, Inc. “These unfair PBM practices harm independent pharmacies, limit patient choice and access to care, and result in poorer medication adherence and health outcomes, all while increasing costs for patients and taxpayers. The Pharmacists Fight Back Act brings these unfair practices to a screeching halt and will restore transparent market-based pricing for patients and pharmacies. APCI proudly endorses the Pharmacists Fight Back Act, and we extend our gratitude to Representatives Auchincloss, Comer, and Harshbarger for their work in introducing this legislation.”
“Big insurers have been gaming the system for years, using PBMs to boost their profits while patients, taxpayers, and local pharmacies pay the price,” said Rachel Madley, PhD, Director of Policy and Advocacy at the Center for Health and Democracy. “The Pharmacists Fight Back Act will rein in profiteering by monopolistic insurers that own PBMs and pharmacies, and lower prescription drug costs for patients who depend on these medications to live.”
“Pharmacy Benefit Managers (PBMs) have long exploited a lack of transparency and accountability, driving up patients’ out-of-pocket costs for life-saving medicines,” said Dr. Robert Popovian, Pharm.D., MS, Pioneer Institute and Global Healthy Living Foundation. “For decades, these intermediaries, who do not contribute to patient care, have evaded federal oversight. The Global Healthy Living Foundation commends bipartisan efforts to rein in PBMs and ensure patients can access innovative medicines at fair, affordable costs.”
While PBMs claim to create "savings" through manufacturer rebates and discounts, those “savings” rarely trickle down to the patient. The Pharmacists Fight Back Act will not only reduce beneficiaries out-of-pocket costs by passing rebates directly back to the patient, but will also ban plans from mandating higher priced brand name drugs over lower priced generics on formularies, foster transparency and promote fairness in the system by prohibiting PBMs from steering patients to their own pharmacies; not to mention the hefty fine PBMs will pay for each violation,” said Madelaine Feldman, MD, FACR; Rheumatologist; Vice President, Advocacy & Government Affairs; Coalition of State Rheumatology Organizations.
"AMAC Action, the advocacy affiliate of the Association of Mature American Citizens (AMAC), with 2 million members nationwide, strongly supports the Pharmacists Fight Back Act,” said Andy Mangione, Senior Vice President of AMAC Action. “PBMs have exploited their power for years, driving up drug prices while squeezing the very pharmacies seniors rely on. Seniors deserve a system built on transparency, accountability, and respect for the pharmacists who keep them healthy. AMAC Action stands firmly with those demanding real reform and an end to PBM practices that put profits ahead of patient well-being.”