House Oversight Committee Ranking Member James Comer (R-KY) told Breitbart News in an exclusive comment Tuesday that Democrats’ Build Back Better Act big pharmaceutical carveouts puts Americans last by driving up prescription drugs.
Comer spoke to Breitbart News as the Senate considers the $4.9 trillion Build Back Better Act. The Democrats’ behemoth legislation, among several other leftist measures, would prohibit implementation of the Trump administration rule that eliminated rebates negotiated between drug manufacturers and pharmacy benefit managers (PMBs.) The Trump administration rule was set to become effective on January 1, 2022, but the Joe Biden administration delayed implementation to 2023 as the Senate considers this legislation.
Comer said the legislation would raise drug prices on Americans.
“Democrats talk a big game when it comes to lowering prescription drug prices, but their Build Back Broke agenda actually increases costs for Americans,” Comer explained to Breitbart News. “President Trump took action to provide prescription drug savings to patients at the pharmacy counter, but Democrats are trying to repeal this commonsense rule. Why are Democrats putting the interests of pharmacy benefit managers first and those of Americans last?”
The Oversight Committee Republicans released a study on how PBMs have raised prescription drug prices.
The Oversight Republican study found:
- PBMs require prior authorization before a patient is given a prescription. PBMs also push “fail first” practices, in which a drug must either prove ineffective or intolerable before they opt for another drug. Patients often must “fail first” on a more expensive drug before opting for a less expensive alternative. Oversight Republicans contend that PBMs have a “financial incentive” to force the patient on a more expensive option.
- PBMs use leverage to increase profits while not passing on savings to consumers. Pharmaceutical companies agree to pay discounts, or pay rebates, to get their products more favorably on a formulary, or the list of drugs that an insurance plan can cover.
- PBMs own their own pharmacies, creating conflicts of interest, hurting competition, and distorting markets. The Oversight Republicans noted that the three largest PBMs —CVS Caremark, Express Scripts, and Optum RX — own pharmacies. These three PBMs control 80 percent of the market, in which they often “steer” patients to the pharmacies they control. PBMs often reimburse unaffiliated pharmacies at lower.
- PBMs also engage in “spread pricing” by paying a pharmacy lower amount what they report to a health plan sponsor, in which they pocket the difference. These PBMs have overcharged state Medicaid programs in Ohio, Kentucky, Illinois, and Arkansas more than $415 million once their spread pricing schemes were discovered.
The Biden White House has touted that the Build Back Better Act will lower the cost of prescription drugs even though scrapping the Trump PBM rule might lead to higher costs for Americans.
The Biden White House also scrapped a Trump executive order aimed at lowering the cost of insulin and epinephrine.
The Oversight Republicans noted that there are 22 Republican and bipartisan legislative solutions to help lower drug costs and address the issues surrounding PBMs, including the Lower Costs, More Cures Act of 2021.
Comer told Breitbart News that their study shows that drastic reform is needed in the healthcare industry.
He said, “Oversight Committee Republicans’ examination of this issue makes it clear greater transparency and meaningful reform are needed over these middlemen who are driving up costs for patients to increase their bottom line, but Democrats seem intent to give them a free pass.”
Sean Moran is a congressional reporter for Breitbart News. Follow him on Twitter @SeanMoran3.