Senate health package includes surprisingly aggressive drug pricing reforms

Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) on Thursday unveiled an unexpectedly ambitious plan to lower the price of prescription drugs. The draft legislation includes several proposals that have the potential to upend PBMs, such as banning spread pricing.

Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) on Thursday unveiled an unexpectedly ambitious plan to lower the price of prescription drugs. The draft legislation includes several proposals that have the potential to upend PBMs, such as banning spread pricing. The proposal would also mandate that PBMs report a swath of information to their clients, including the net and list price for each drug and the amount of the rebates they receive. The proposal would also require PBMs to pass on 100% of the rebates or discounts they negotiate to their clients. "This definitely reads like a straight-up ban. You can't put the language much more clearly," said Antonio Ciaccia, director of government and public affairs at the Ohio Pharmacists Association. The move was also applauded by the National Community Pharmacists Association, which has largely led the charge against spread pricing, which the group alleges often unfairly benefits pharmacies owned by PBMs, like CVS. Alexander and Murray are known for advancing policies that eventually become law, leading many observers to conclude their measure has a good chance of passage. Meanwhile, House Speaker Nancy Pelosi is reportedly coming closer to finalizing a drug-pricing plan aimed both at mollifying progressives and potentially earning support from Republicans.