The Association of Community Pharmacists is challenging Congress to fix what it calls are hidden fees and abusive practices by the pharmacy benefit management industry.
According to ACP's Congressional Network, PBMs are "the primary source of inflated prescription costs and rising patient anger."
"Members of Congress need to address the secret PBM practices that pharmacies in their districts have uncovered – PBM corporations are underpaying local pharmacies, misusing confidential patient information and hiding money owed to taxpayers," said Mike James, the ACPCN's vice president for government affairs. "The time for comprehensive Congressional action is overdue."
ACP officials say its Congressional Network has helped thousands of pharmacy owners provide evidence to Congress that PBMs underpay local pharmacies for prescriptions and then hide the underpayments from insurers and government plans to inflate PBM profits.
There have also been claims that PBMs are taking patient data from community pharmacies and using it to send threatening letters to their patients. This forces patients into PBM-owned pharmacies and mail-order programs instead of local pharmacies.
The ACP's Congressional Network is lobbying for HR 4199, the so-called "Pharmacy Bill." The bill would place greater emphasis on the use of generic drugs, local pharmacies and other cost-containment measures to reduce prescription costs for taxpayers and consumers by more than $250 billion over 10 years, according to a report for the ACPCN by a former analyst of the Congressional Budget Office.
Others disagree about the effects of PBMs and HR 4199. Mark Merritt of the Pharmaceutical Care Management Association has said the bill will cost taxpayers $186 billion. The PCMA has launched a multi-million-dollar campaign to defeat HR 4199.
"The typical pharmacy in a local community cares for hundreds of patients daily and earns a few pennies on the dollar after paying for inventory, rent, salaries and other expenses," said James.