Kingsport Reporter

Washington, D.C. - On April 25, Congresswoman Diana Harshbarger introduced H.R. 2816, the PBM Sunshine and Accountability Act, a bipartisan bill which will establish new, public reporting requirements for Pharmacy Benefit Managers (PBMs), to ensure that patients, providers, and employers are able to make informed, cost-efficient, and value-based PBM choices. 

The PBM Sunshine and Accountability Act would amend current law to require PBMs to publicly report additional information to the Department of Health and Human Services (HHS), including: 

1. Aggregate dollar amount of all rebates, administrative fees, and other revenue the PBM receives from drug manufacturers and healthcare entities 
2. Highest, lowest, and total retained rebate percentages
3. Post-adjudication payments or clawbacks that PBMs extract from pharmacies

“For far too long, PBM middlemen have exploited a lack of transparency and created conflicts of interest in ways significantly distorting competition at consumer expense – and where there’s mystery, there’s margin,” said Congresswoman Diana Harshbarger. “My PBM Sunshine and Accountability Act will finally require PBMs to report critical financial information on their operations, which will enable patients and providers to see which PBMs are adding value, and which ones are printing their own money. This legislation will shine a bright light on the ways that PBMs avoid regulation and siphon off countless dollars from our supply chains, and equip policymakers to prevent these practices to save healthcare dollars.” 

The PBM Sunshine and Accountability Act has bipartisan support, with Representatives Abigail Spanberger (D-VA), Mariannette Miller-Meeks (R-IA), and Raja Krishnamoorthi (D-IL) as original co-sponsors. 

“During this moment when PBMs hold tremendous power across the American pharmaceutical industry, we need to know if the behaviors of these middlemen are contributing to higher drug prices for American consumers,” said Spanberger. “By increasing reporting requirements, our PBM Sunshine and Accountability Act would help shed more light on the murky world of PBMs. Our bipartisan bill would give Congress more tools to dig into their practices — and it would give the American people more information about how PBMs might be manipulating the sticker prices of medications. In this way, we can pursue reforms that will lower drug costs for the Virginians I serve.”

“We can all agree the issue of rising drug costs must be addressed, and PBMs often fall in the center of this controversy,” said Miller-Meeks. “Our bill, the PBM Sunshine and Accountability Act, will require PBMs to report critical data that will help patients and providers to make informed decisions. I’m proud to join in leading this important, bipartisan bill to shed light on PBM practices.”

“Patients and providers need greater transparency in the prescription drug market to ensure they are receiving the discounts and rebates they deserve,” said Krishnamoorthi. “I am proud to join my colleagues in introducing our bipartisan legislation to bring more accountability to the practices of pharmacy benefit managers, which will ultimately help bring down the costs of prescription drugs for Illinoisans and all Americans.”

The legislation is also backed by healthcare advocacy organizations such as the Alliance for Transparent and Affordable Prescriptions (ATAP) and Patients Rising. 

"The Alliance for Transparent and Affordable Prescriptions (ATAP) looks forward to continuing our work on Capitol Hill and in state legislatures to advocate for legislation like the PBM Sunshine and Accountability Act, which shines much-needed light on the PBM industry, " said Robert Levin, MD, the President of ATAP. "The transparency offered by this legislation will help policymakers see what is really happening in our exam rooms, and our patient’s wallets, due to abusive PBM practices. Transparency legislation requiring the PBM industry to disclose price concession and other key information is a victory for all patients, and the disclosed information will help lawmakers and regulators identify reforms that will put an end to abusive PBM practices."

“We applaud Representatives Harshbarger, Spanberger, Miller-Meeks, and Krishnamoorthi for their leadership on this much needed bipartisan legislation. Patients need real savings now more than ever." said Terry Wilcox, Co-Founder and CEO of Patients Rising. “This starts with bringing long overdue transparency to PBMs and their practices. Pharmacists and the patients they help deserve it.”

A summary of the bill can be found here.

The full text of the bill can be found here.

Original source can be found here.