LA JOLLA, CALIFORNIA – April 17, 2024 – West Health unveils critical insights into the ongoing debate over Pharmacy Benefit Manager (PBM) reforms. With bipartisan support for legislative action at an all-time high, the stakes have never been higher.
Key Points:
Bipartisan Momentum: Scrutiny of PBM practices has come to center stage, galvanizing bipartisan support for legislative reform.
Reform Focus: Current Congressional proposals zero in on regulating how PBMs earn money, raising concerns about potential repercussions for negotiation effectiveness and market dynamics.
Expert Analysis: Proposed reforms have raised questions about whether PBMs can remain incentivized to negotiate lower prices for drugs while sharing the benefits with payers and consumers. In a groundbreaking analysis, ATI Advisory examines proposed reforms and identifies opportunities to address this question by encouraging competition, increasing accountability, and addressing vertical integration.
Call to Action: As Congress prepares to revisit the topic of PBM reform, West Health urges stakeholders to consider several adjustments outlined in this report to enhance the current policies that prioritize consumers and harness the power of competition.
For media inquiries or interviews with the authors, please contact Tiffany Yu, Manager, Content and Communications, West Health, tyu@westhealth.org.
Pharmacy Manager Reforms: Can Congress Fix the Market Without Breaking It?
Executive Summary: https://www.westhealth.org/publications/pharmacy-benefits-manager-reforms-can-congress-fix-the-market-without-breaking-it/
Full Report: https://www.westhealth.org/publications/executive-summary-pharmacy-benefits-manager-reforms-can-congress-fix-the-market-without-breaking-it/
About West Health
Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego, and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org and follow @westhealth.
About ATI Advisory
ATI Advisory is a healthcare research and advisory services firm dedicated to system reform that improves health outcomes and makes care easier for everyone. ATI guides public and private leaders in developing scalable solutions. Its nationally recognized experts apply the highest standards in research and advisory services along with deep expertise to generate new ideas, solve hard problems, and reduce uncertainty in a rapidly changing healthcare landscape. For more information, visit www.atiadvisory.com.
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