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PBM Legislative Update: Which Provisions Stand the Best Chance of Making It Into a Final Bill and Become Law? | AMCP Nexus 2023
Melissa Andel, M.P.P., sees delinking of administrative fees to drug prices and various transparency and disclosure provisions as likely to make it into a final pharmacy benefit manager (PBM) legislation making it into a final bill.
It is safe to say that pharmacy benefit managers (PBMs) are not among the priorities in Washington right now with the Israel-Hamas conflict raging and the House without a speaker.
But in an interview conducted before of Academy of Managed Care Pharmacy (AMCP) Nexus meeting, Melissa Andel, M.P.P., said she believe sthere is a chance of PBM legislation passing this year and that it will include provisions with wide support, such as the delinking of PBM administrative fees from the list price of drugs and new transparency and disclosure requirement.
Currently there is one consolidated PBM bill in the House but three seperate ones in the Senate.
Andel, whose healthcare consulting business is called CommonHealth Solutions, spoke yesterday at the AMCP Nexus 2023 meeting in Orlando.
Andel said it was open question whether any rules uncoupling administrative fees from prices will be applied to commercial plans and Medicare Part D plans or just Medicare Part D.
The proposals about transparency and disclosure vary. Andel said disclosure transparency into t pricing strategy and negotiations may have some unintended consequences. “I know if you speak to economists, they argue that when you go into negotiation, the promise of confidentiality is always going to result in a different agreement than what would have otherwise been reached if all the parties know at some point the negotiation will be made public.”
Andel said “there are theories out there that say the negotiations will not be as aggressive as they are today.”
Bridging the Diversity Gap in Rare Disease Clinical Trials with Harsha Rajasimha of IndoUSrare
November 8th 2023Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.
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Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series.
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Air Pollution May Negatively Affect Male Reproductive Health
November 30th 2023A potential mechanism by which air pollutants may affect reproductive health is by endocrine disruption. Air pollutants are made up of mixtures of particulate matter that may include endocrine disruptors, such as polycyclic aromatic hydrocarbons (PAHs) and heavy metals.
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35th World AIDS Day Marks 20 Years of PEPFAR: Challenges and Strategies to Combat HIV/AIDS
November 29th 2023PEPFAR, having invested $100 billion and saved 25 million lives in the global fight against HIV/AIDS, faces Congressional hurdles in its reauthorization due to abortion debates. Despite widespread support and no evidence of abortion-related activities, the legislative process is at a standstill. Members of PEPFAR and authors of a recent editorial stress the significance of PEPFAR and advocate for integrating behavioral and social science into healthcare programs to achieve UNAIDS targets and address barriers in HIV/AIDS testing and treatment.
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