Specialty Pharmacy Supports State Effort to Regulate PBM Practices
T
he National Association of Specialty Pharmacy (NASP) filed an amicus brief on March 2, 2020, in support of the case going before the Supreme Court on April 27, 2020 to decide on states' rights to regulate pharmacy benefit managers (PBMs).
The case Rutledge v. the Pharmaceutical Care Management Association (PCMA) will determine whether states can regulate pharmacy reimbursement and oversee PBM practices, or whether the Employee Retirement Income Security Act (ERISA) preempts states from regulating such practices.
The bottom line is that many specialty pharmacies are being reimbursed below their cost to acquire a drug and support patients in safely using their specialty medications. Such practices are intended to limit specialty pharmacy networks and steer patients toward specialty pharmacies that are owned and operated by the largest PBMs and plans, said Sheila Arquette, NASP Executive Director. NASP is pleased that the Supreme Court will rule on the case and is confident a ruling will ultimately support specialty pharmacy patients and the pharmacies that serve them. Anticompetitive business practices threaten a specialty pharmacy's ability to care for their patients, jeopardizing the lives of patients living with such conditions as cancer, rheumatoid arthritis, multiple sclerosis, cystic fibrosis and HIV/AIDS, said Arquette.
NASP's brief outlines the impact of these practices on specialty pharmacy businesses and specialty pharmacy patients.
Since 2012, NASP members have seen a dramatic growth in the collection of pharmacy price concessions in the form of Direct and Indirect Remuneration (DIR) clawback fees by plans and their PBMs not only in Medicare but also in the commercial sector.
We cannot allow the largest PBMs leeway to continue anticompetitive market practices that limit consumer access to the specialty pharmacies they need for their complex health conditions, says Arquette. It is our hope that the Supreme Court will protect states' rights to oversee and control these abusive practices.
Contact Sheila Arquette, Executive Director, info@naspnet.org (703) 842-0122
✔️ Specialty Pharmacy Supports State Effort to Regulate PBM Practices
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