Metro East Sun

Citizens Against Government Waste (CAGW) has come out strong in opposition to federal pharmacy legislation co-sponsored by U.S. Rep. Rodney Davis (R-IL).

CAGW says H.R. 244, the MAC Transparency Act, would raise costs for consumers and taxpayers.

H.R. 244 would amend Medicare Part D's voluntary prescription drug benefit program to require pharmacy benefit managers (PBMs), who process and pay prescription drug claims, to update drug prices at least once every seven days and disclose the sources used to make the adjustment.

CAGW says those changes would interfere with market negotiations. 

"The bill remains an issue for CAGW because adopting a proposal such as H.R. 244 would interfere with the intense negotiations that occur between PBMs, pharmaceutical companies and pharmacists by revealing sensitive financial information," Elizabeth Wright, CAGW's director of health and science policy, told the Metro East Sun.

Such a move, said Wright, would undermine these stakeholders' negotiations, which thus far have succeeded in driving down the cost of prescription drugs.

  

“MACs (maximum allowable cost) are utilized by PBMs to prevent them from paying significantly more than the average acquisition cost by pharmacists for generic drugs," Wright said. "MACs encourage pharmacists to shop around for the lowest-priced generic drugs. And MACs have been used successfully by PBMs in Medicare Part D to keep prices down for beneficiaries and taxpayers."

  

CAGW first weighed in with Congress on the issue in May 2015 -- soon after H.R. 244 was introduced -- and again in February of this year when there were efforts to push for hearings on the issue, Wright said.

A similar proposal, she noted, was contained in a January 2014 Center for Medicare and Medicaid Services’ proposed rule, “Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs,” which subsequently was withdrawn later that year due to intense opposition from members of Congress and other stakeholders.

“So far, Congress has not adopted such a proposal," Wright said. "CAGW is grateful that most members of Congress understand this bill [H.R. 244] is another effort by independent pharmacies to influence the government to help them make a larger profit at the expense of taxpayers."

Furthermore, she added, doing so would foster tacit collusion and reduce the ability of PBMs to negotiate discounts with pharmacies and rebates with drug manufacturers, thereby leading to higher prescription drug prices and an increase in total prescription drug spending.

  

At the same time, the bill would stifle the use of mail-order pharmacies, which provide convenience, and specialty pharmacies providing specialized care that save consumers, employers and other payers billions of dollars, according to the CAGW.

Rep. Davis sees the bill as a means to help provide affordable health care. 

"As the husband of a cancer survivor and the father of three children, I understand how important it is for all families and individuals to have access to good, affordable health care,"said Rep. Davis. "Ensuring families and individuals throughout the 13th District have access to affordable health care is a top priority of mine."

Wright disagrees and says CAGW will continue opposing H.R. 244, which has been referred to the U.S. House Military Personnel Subcommittee.