New Senate Bill Would Require PBMs to Disclose Some Rebate Data

Transparency, Quality and Cost Containment

Senator Ron Wyden (D-OR) recently introduced the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2017 (S. 637), which would require pharmacy benefit managers to publicly post aggregated data about rebates and discounts that are obtained on behalf of Medicare Part D and Medicare Advantage plans.  Specifically, S. 637 would require disclosure of spread pricing, which is the difference in payments made to pharmacies by PBMs compared to payments received by PBMs made by health plans.  It would also require the disclosure of information about the so-called negotiated price.  Under current law, Part D beneficiaries pay co-insurance based on the $100 price, not the lower price that a PBM negotiates with a drug manufacturer.  According to Sen. Wyden: "It's time to lift the veil of secrecy on a powerful industry that claims it is bringing down the prices of medicines that Americans pick up at their pharmacy."  He plans to attach the bill to "every possible" legislation that addresses health care.  Opposing the measure, the Pharmaceutical Care Management Association said, "The C-THRU Act would grant the kind of transparency that the Federal Trade Commission and economists say will raise costs by giving drug companies and drugstores unprecedented access to a health plan's negotiations with their competitors.  This mandate would give drug companies and drugstores inside information that could help them tacitly collude with their competitors."  Separately, HHS Secretary Price said in a House hearing this week that he is partnering with the White House on a strategy for tackling drug pricing reform.