The Biosimilars Forum Supports House Committee on Oversight and Accountability Probe Into the PBM Monopoly

The Three Largest PBMs Control More Than 80 Percent of the Industry

Juliana M. Reed, Executive Director the Biosimilars Forum, released the following statement after the House Committee on Oversight and Accountability released a groundbreaking report on how the Pharmacy Benefit Manager (PBM) Monopoly hurts patients by steering them towards higher-cost prescription drugs. The House Committee on Oversight and Accountability also held a hearing titled “The Role of Pharmacy Benefit Managers in Prescription Drug Markets Part III: Transparency and Accountability.” This hearing highlighted that PBMs undermine patient health and increase drug costs. This comes on the heels of a report from the Federal Trade Commission (FTC) with similar findings – that PBMs intentionally force patients onto high-cost, high-rebate drugs.

“The report from the House Committee on Oversight and Accountability and important hearing by the Committee with PBM leaders confirm the PBM Monopoly actively denies patients access to lower-cost, safe, and effective drugs – including biosimilars. Congress must deliver comprehensive PBM reform legislation so patients can more easily access their life-saving drugs.

“The Forum appreciates the U.S. Representatives asking PBM leaders questions that are important to millions of patients throughout the country that are paying too much for their prescriptions. 

“PBMs continue to prioritize profits over patients. The report finds that “patients are seeing significantly higher costs with fewer choices and worse care.” Congress must address the PBM Monopoly. The three largest PBMs control more than 80 percent of the market, which means they determine what medications patients can take – not their doctors. The PBM system must be reformed. We all need to put patients first.

“The PBM Monopoly alleges that their business model improves patient access and lower costs. This is categorically false. Rather, their unethical business practices and exclusionary schemes prevent lower-cost drugs from reaching patients. This is especially problematic when lower-cost biosimilars can save the U.S. health care system up to $133 billion if they are accessible.

“It is clear that biosimilars are the commonsense, free-market solution to skyrocketing prescription drug prices. This includes adalimumab biosimilars — which reference the best-selling drug in the world Humira® — and could have offered savings of up to $6 billion to the U.S. health care system if they had formulary access. Yet, the PBM Monopoly deny patients access to adalimumab biosimilars that are up to 85% lower cost.

“The time to act is now – policymakers cannot wait any longer. The Biosimilars Forum stands ready to work with both sides of the aisle and the Administration to help patients better afford their prescription drugs. But without reform, the cost-savings promise of biosimilars could be lost forever.”

For more information on the Biosimilars Forum’s work to increase access to lower-cost biosimilars, visit biosimilarsforum.org.