A Rare Instance of Bipartisanship: Congress’ Unified Approach to PBM Reform

Vincent Giglierano, senior manager of health services research for Faegre Drinker Consulting, authored an article for Innovations Magazine discussing the high costs of medication and proposed reform and legislation to make those prescriptions more accessible.

In the article, Giglierano encourages examining the Lower Costs, More Transparency Act (LCMT) and the Modernizing and Ensuring PBM Accountability Act (MEPA Act). Both legislations push for more transparency of PBM operations and prohibition or limitations on the use of spread pricing. 

Synchronous with the legislation are robust reporting requirements and transparency provisions – PBMs must submit detailed reports to plan sponsors disclosing drug pricing, including wholesale costs, out-of-pocket expenses for beneficiaries and the total amounts of received from drug manufacturers in rebates or other renumerations.

Giglierano notes that the bills represent a meaningful stride toward demystifying the complex drug pricing system, potentially leading to more affordable medications for millions of Americans.