Patients with cancer and other healthcare consumers would receive reinforcements in the fight against financial toxicity with new legislation that would “empower the Federal Trade Commission (FTC) to increase drug pricing transparency and hold pharmacy benefit managers (PBMs) accountable for unfair and deceptive practices that drive up the costs of prescription drugs.” U.S. Senators Maria Cantwell (D-WA) and Chuck Grassley (R-IA) introduced the proposed bill in May.
Named the Pharmacy Benefit Manager Transparency Act of 2022, the bill’s key features include:
- Prohibiting PBMs from arbitrary, unfair, or deceptive financial practices
- Incentivizing fair and clear practices with exceptions to liability for PBMs
- Requiring PBMs to report:
- The money they make from sources
- Difference in fees or reimbursement rates
- When and why they shift a drug’s formulary tier
- Requiring FTC to report to Congress any enforcement of the act and whether PBMs engage in unfair behavior
“The increasing cost of prescription drugs has a devastating effect on the pocketbooks of American consumers,” Cantwell said. “PBMs are the middlemen in the prescription drug supply chain and it’s time for Congress to give FTC the ability to shine a brighter light on any deceptive and abusive practices.”
“Senator Cantwell and Senator Grassley’s critical legislation will help stop PBM abuses and bring much-needed transparency to the shroud of secrecy they operate in,” Ted Okon, executive director of the Community Oncology Alliance, said. “The top PBMs use their inordinate market leverage to delay and even deny patients their cancer medications, lowball payments to pharmacists resulting in pharmacy closures, and fuel drug health care costs for all Americans. The Senators’ leadership is so critical and appreciated.”
Cancer treatment is a significant investment for patients, including their cost for prescription drugs. Lack of adequate coverage can affect a patient’s physical and emotional well-being, quality of life, and overall cancer outcomes. All people should have access to affordable health care, and it is an oncology nurse's responsibility to promote equal access.