Health Care
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Health Care
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Pharmacy benefit manager (PBMs) executives will appear before the House Oversight Committee Tuesday to face what is likely to be a bipartisan grilling over whether the companies are contributing to the high costs of prescription drugs. |
Executives from the three biggest PBMs — CVS Caremark, OptumRx and Express Scripts — are expected to testify.
PBMs negotiate the terms and conditions for access to prescription drugs for hundreds of millions of Americans. They are responsible for negotiating prices with drug companies, paying pharmacies and determining which drugs patients can access and how much they cost.
The GOP-led House Oversight and Accountability Committee has been one of the committees investigating PBMs, though it’s not one that’s been involved in negotiating legislation.
Congressional pressure on PBMs has been building, and bipartisan bills to change certain PBM business practices have cleared two Senate committees. But major policy disagreements between House and Senate Republicans in terms of the scope of the changes led to them being sidelined, likely until a lame duck session after the November elections.
The hearing Tuesday could be an effort to jumpstart efforts to include PBM reforms in any year-end spending package.
“Both Republicans and Democrats on the House Oversight Committee have sounded the alarm over anticompetitive tactics deployed by pharmacy benefit managers and their role in rising drug prices,” Oversight Committee Chair James Comer (R-Ky.) said in a statement.
“Information the Committee has obtained shows spread pricing and rebates benefit PBMs and have helped the three largest PBMs monopolize the pharmaceutical market,” Comer said.
Drugmakers blame PBMs for the high costs of prescription drugs, though the PBM industry says their role is misunderstood. Executives at the hearing are likely to point fingers at the manufacturers.
“Too many recent conversations around PBMs reflect a one-sided view informed directly by the pharmaceutical industry’s blame game designed to vilify PBMs to keep prescription drug prices high and increase drug company profits,” said JC Scott, president and CEO of the PBM trade group Pharmaceutical Care Management Association. |
Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel and Joseph Choi — every week we follow the latest moves on how Washington impacts your health. |
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How policy will be impacting the health care sector this week and beyond: |
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Vice President Kamala Harris, who said she will seek the Democratic nomination after President Biden decided not to continue his reelection campaign, has previously staked out health positions to the left of President Biden. But there isn’t expected to be much daylight between her policy priorities and President Biden’s. Harris will be able to claim ownership of Biden’s health wins—like a $35 insulin cap, Medicare drug … |
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Gov. Chris Sununu (R-N.H.) signed a bill into law on Friday that bans health professionals from performing gender-affirming surgeries for minors. Sununu signed another bill that will ban transgender athletes from competing on school sports teams that align with their gender identity. The third bill the governor signed allows parents to have their kids opt out of public school teaching that involves “sexual orientation, gender, … |
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Upcoming news themes and events we’re watching: |
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The House Oversight and Accountability Committee on Tuesday looks at the transparency and accountability of pharmacy benefit managers
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CDC center directors testify Tuesday at a House Energy and Commerce subcommittee hearing on agency priorities and restoring the public trust
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The Senate HELP Committee on Thursday will vote on a subpoena of Steward Health CEO Ralph de la Torre
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Branch out with a different read from The Hill: |
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Woman gets probation for calling in hoax bomb threat at Boston Children’s Hospital |
A Massachusetts woman has been sentenced to three years of probation for calling in a fake bomb threat at Boston Children’s Hospital as it faced a barrage of harassment over its surgical program for transgender youths. Catherine Leavy pleaded guilty last year in federal court to charges including making a false bomb threat. Authorities … |
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Local and state headlines on health care: |
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Health news we’ve flagged from other outlets: |
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What to know about cheaper, imitation weight-loss drugs (Washington Post)
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Political rhetoric about third trimester abortion is misleading, experts say (News From The States)
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Rescue from above: how drones may narrow emergency response times (KFF Health News)
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Most read stories on The Hill right now: |
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President Biden is out of the 2024 race and backing Vice President Harris to take over his mantle in November, raising questions about what the polling … Read more |
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LGBTQ Americans and advocacy groups are sounding alarm bells over the selection of Sen. JD Vance as former President Trump’s running mate. In … Read more |
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Opinions related to health submitted to The Hill: |
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