Reporter: Mark Swanson
Rep. Jake Auchincloss, D-Mass., is taking aim at three pharmacy benefit managers (PBMs) that operate without congressional scrutiny to the tune of extracting $300 billion annually from the U.S. healthcare system, telling Newsmax they bastardized a critical industry role to feed their greed.
Meanwhile, drug prices continue to soar for Americans.
Auchincloss joined "The Record With Greta Van Susteren" to say the 119th Congress needs to rein in Cigna's Express Scripts, CVS Caremark, and Optum Rx of UnitedHealthcare Group. While the names are known, many Americans don't know what they do, and that's intentional, he said.
PBMs "like being in the middle of a complicated supply chain, and they are shielded from public scrutiny and congressional scrutiny. They can be rent-seekers, and they are taking about $300 billion from the U.S. healthcare system every year," Auchincloss said.
PBMs "process claims and reimbursement ... for the pharmaceuticals ... that you buy at pharmacies throughout the country. And in that role, a lot of money crosses their transom. And they got greedy.
"It's time to rein them in. We can save taxpayers $5 billion and lower co-pays and premiums with bipartisan legislation that we had on the docket ready to pass last Congress," he said.
Auchincloss said PBMs are designed to serve a role that is needed in the industry.
"The original reason for them — and we do actually need somebody to do this role — is to design and enforce a formulary. And what that really means is it says to the big pharmaceutical companies: 'If you have a brand drug which is expensive and there's a generic drug which is cheap but does the same thing therapeutically, the patient needs to try the generic drug first," he said.
"And that lowers prescription drug costs over time because it creates competition and choice. That's a good thing. We actually need someone to do that.
"They should be charging a flat rate though for that service, like 1[%] or 2% probably. Instead, [PBMs] have squirreled themselves into this supply chain and have been extracting rents not based on a flat rate, but rather the higher the drug price goes, the more they get paid," he said... CONTINUE READING
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