EmpiRx Health Applauds Congressional Efforts to Reform PBM Industry Practices
In a bold move towards altering the business dynamics of pharmacy benefits management (PBM), EmpiRx Health has publicly praised Congress members Brett Guthrie and Earl L. 'Buddy' Carter for their commitment to reforming practices of the leading PBM companies that have long been criticized. The two congressmen convened a critical hearing, aptly titled 'An Examination of How Reining in PBMs Will Drive Competition and Lower Costs for Patients,' which aimed to ignite the much-needed reforms in the PBM industry,
This initiative comes in response to the rising costs of prescription medications, a pressing concern that affects millions of Americans. As the healthcare landscape grapples with escalating drug prices, especially with the increased prevalence of specialty drugs, the role and accountability of PBMs have come under scrutiny. Originally established over five decades ago to help organizations manage pharmaceutical expenses better, many PBMs now tend to prioritize profitability over improving health outcomes.
EmpiRx Health's CEO, Danny Sanchez, emphasized the urgent need for comprehensive changes within the realm of PBMs that have increasingly drifted away from their founding mission of cost containment and patient care. 'If Congress is serious about lowering drug costs for Americans, PBM reform must be part of that conversation,' he states, underscoring that current trends show annual drug costs rising more than 5%. This situation persists while PBMs reap higher profits instead of prioritizing the needs of patients and benefit plan sponsors.
The hearing convened by Congressman Guthrie and Carter is seen as a pivotal moment in attracting bipartisan responses compared to previous attempts at reform. With over 80% of the pharmacy care market controlled by merely three dominant PBMs, the system's integrity is in jeopardy. These firms have transformed into profit-oriented entities reminiscent of financial trading houses rather than health-focused organizations.
Sanchez noted that the strategies often deployed by legacy PBMs have contributed to soaring drug prices rather than ameliorating them. He advocates for key PBM reforms that have gained bipartisan support over the past year. Measures such as eliminating spread pricing, ensuring full rebate pass-throughs to plan sponsors, and intensifying transparency requirements are crucial if we aim to uproot the dysfunctional models that have plagued the industry for too long.
To further enhance the effectiveness of these reforms, Sanchez argues the necessity of addressing anticompetitive practices within the PBM sector. The vertical integration that allows these entities to compete with themselves by owning both PBMs and pharmacies creates conflicts of interest that hinder patient care. EmpiRx Health firmly supports legislation like the Patients Before Monopolies (PBM) Act proposed by influential Senators and Representatives, aiming to prohibit such collective ownership practices.
The overarching goal, according to Sanchez, is to pave the way for a future where PBMs return to their roots—not just as facilitators of drug cost management, but as organizations that genuinely care for patient health. EmpiRx Health’s clinically-driven approach, emphasizing the central role of pharmacists in healthcare, stands as a testament to this vision. By utilizing its AI-powered pharmacy care platform Clinically™, EmpiRx Health has been committed to improving patient outcomes and significantly reducing prescription drug costs, showcasing a model that emphasizes patient care above all.
As the discussions around PBM reform advance, EmpiRx Health looks forward to collaborating with Congress to advocate for solutions that bring meaningful change to the pharmacy care landscape. This collaborative effort is fundamental to reinstating the integrity of PBM services and ensuring that the healthcare needs of everyday Americans take priority over corporate profits.
This initiative comes in response to the rising costs of prescription medications, a pressing concern that affects millions of Americans. As the healthcare landscape grapples with escalating drug prices, especially with the increased prevalence of specialty drugs, the role and accountability of PBMs have come under scrutiny. Originally established over five decades ago to help organizations manage pharmaceutical expenses better, many PBMs now tend to prioritize profitability over improving health outcomes.
EmpiRx Health's CEO, Danny Sanchez, emphasized the urgent need for comprehensive changes within the realm of PBMs that have increasingly drifted away from their founding mission of cost containment and patient care. 'If Congress is serious about lowering drug costs for Americans, PBM reform must be part of that conversation,' he states, underscoring that current trends show annual drug costs rising more than 5%. This situation persists while PBMs reap higher profits instead of prioritizing the needs of patients and benefit plan sponsors.
The hearing convened by Congressman Guthrie and Carter is seen as a pivotal moment in attracting bipartisan responses compared to previous attempts at reform. With over 80% of the pharmacy care market controlled by merely three dominant PBMs, the system's integrity is in jeopardy. These firms have transformed into profit-oriented entities reminiscent of financial trading houses rather than health-focused organizations.
Sanchez noted that the strategies often deployed by legacy PBMs have contributed to soaring drug prices rather than ameliorating them. He advocates for key PBM reforms that have gained bipartisan support over the past year. Measures such as eliminating spread pricing, ensuring full rebate pass-throughs to plan sponsors, and intensifying transparency requirements are crucial if we aim to uproot the dysfunctional models that have plagued the industry for too long.
To further enhance the effectiveness of these reforms, Sanchez argues the necessity of addressing anticompetitive practices within the PBM sector. The vertical integration that allows these entities to compete with themselves by owning both PBMs and pharmacies creates conflicts of interest that hinder patient care. EmpiRx Health firmly supports legislation like the Patients Before Monopolies (PBM) Act proposed by influential Senators and Representatives, aiming to prohibit such collective ownership practices.
The overarching goal, according to Sanchez, is to pave the way for a future where PBMs return to their roots—not just as facilitators of drug cost management, but as organizations that genuinely care for patient health. EmpiRx Health’s clinically-driven approach, emphasizing the central role of pharmacists in healthcare, stands as a testament to this vision. By utilizing its AI-powered pharmacy care platform Clinically™, EmpiRx Health has been committed to improving patient outcomes and significantly reducing prescription drug costs, showcasing a model that emphasizes patient care above all.
As the discussions around PBM reform advance, EmpiRx Health looks forward to collaborating with Congress to advocate for solutions that bring meaningful change to the pharmacy care landscape. This collaborative effort is fundamental to reinstating the integrity of PBM services and ensuring that the healthcare needs of everyday Americans take priority over corporate profits.
Topics Health）
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