Friday, March 03, 2017

Watch Congress Vent About PBMs on the House Floor

ICYMI: Rep. Doug Collins (R-GA) led a 60 minute rant against pharmacy benefit managers (PBMs) in the U.S. House of Representatives. Joining him were congressmen Brian Babin (R-TX), Buddy Carter (R-GA), John J. Duncan, Jr. (R-TN), Dave Loebsack (D-IA), and Austin Scott (R-GA). It’s an enlightening tour through the usual grievances and conspiracy theories about PBMs.

Regular readers know that I have called out PBMs for the potentially warped incentives embedded in rebate practices and the gross-to-net bubble. See, for example, this article and this one.

But the overheated rhetoric on the House floor was truly jaw dropping. Example: Rep. Collins kicked things off in style by claiming that PBMs engage in “monopolistic, terrorist kind of ways that they are dealing with our community pharmacies and independent pharmacies.”

Terrorists? Really?!? I wonder how ISIS feels about this comparison.

Video, transcript, and additional observations below. Enjoy!


The congressmen played all the greatest hits: maximum allowable costs (MAC) abuse, clawbacks, the use of PBM-owned mail pharmacies, DIR fees, spread pricing, “transparency,” narrow networks, Epipen, and more.

Friendly reminder: I provide a non-partisan, fact-based look at all of these topics in our 2017 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

The congressmen raised a few legitimate concerns, but buried these points in an avalanche of over-the-top criticisms and ad hominem attacks. At least Rep. Carter had the courtesy to mention that prescription drugs improve health!

Click here to read the full transcript from the Congressional Record.

Video below. Click here if you can’t see it.

As you can see, the entire screed unfolded before an empty room, so I suspect it will ultimately have limited impact.

P.S. Technically, Rep. Sessions and his colleagues are complaining that PBMs are oligopsonistic, not monopolistic. I explained the distinction in my 2012 antitrust review of the Express Scripts-Medco merger. Just sayin'!

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