The US pays the highest amount per capita on prescription drugs than any other nation. Several factors interact to drive prices up in the nation. Since a major portion of pharmaceutical development occurs in the US, drugmakers argue high prices are necessary to offset research costs and promote exclusivity. In addition, pharmacy benefit managers (PBMs) play a large role in setting drug prices because they negotiate formularies and drug rebates.
A bipartisan bill including reforms to the Food and Drug Administration (FDA) and the pharmacy benefit manager (PBM) industry has been advanced by the US Senate Health, Education, Labor, and Pensions committee. The bill, approved with an 18-3 vote, picked up several amendments in the mark-up session before it was advanced.
After a mid-term election in the US that saw the Democrats unexpectedly maintaining control of the Senate, legislative action and congressional hearings into the practices of pharmacy benefit managers (PBMs) will still be on the docket in coming months. The industry has faced increasing scrutiny in recent years for practices that some call anti-consumer and anti-competitive.
As Pfizer waits on a decision as to whether the US Supreme will take on the company’s case against US anti-kickback laws regarding proposed copay assistance programs, several organizations have entered the fray. PhRMA, Johnson & Johnson, and TrialCard have each filed amicus briefs to the highest court of the land to take on the case, which had been previously blocked by circuit court loss.