NCPA: Oversight PBM Hearing, Report Demand Reforms and Enforcement

The National Community Pharmacists Association released the following statement today from its CEO, B. Douglas Hoey, after the House Committee on Oversight and Reform’s hearing with pharmacy benefit manager executives Adam Kautzner, PharmD, president, Evernorth Care Management and Express Scripts; David Joyner, executive vice president, CVS Health, and president, CVS Caremark; and Patrick Conway, MD, chief executive officer, OptumRx: 

“Among members of the Oversight Committee, there was broad support for finalizing comprehensive PBM reforms – and much skepticism about the excuses, and at times downright lies, the PBM executives were attempting to feed them about the roles of their organizations in increasing prescription costs and decreasing patient access to health care. Patient steering, self-dealing formularies, spread pricing, take-it-or-leave-it contracts, the fee-for-nothing scam … legislators have seen enough that the PBM-insurers can no longer obfuscate these important issues. We applaud the committee for its work and encourage its members and the rest of their colleagues in Congress to finish the fight. Finalize PBM reform now and rein in these and other harmful PBM tactics.”

The Oversight Committee launched its investigation into PBMs in March 2023, and its chairman, Rep. James Comer (R-Ky.), spoke at NCPA’s Congressional Pharmacy Fly-In the following month. Today’s hearing was the third in a series of hearings the committee has held since. As part of it, the committee this morning released a report finding that the three largest PBMs – CVS Caremark, Express Scripts, and OptumRx – have prioritized deliberate pricing tactics to line their own pockets.