Biosimilars Forum Applauds House of Representatives Committee on Energy and Commerce for Including PBM Reform in Reconciliation Package

Juliana M. Reed, executive director of the Biosimilars Forum, released the following statement after the House of Representatives Committee on Energy and Commerce included comprehensive Pharmacy Benefit Manager (PBM) reform in its reconciliation package.

“Biosimilars Forum applauds the House of Representatives Committee on Energy and Commerce for including PBM reform in its first draft of the reconciliation package. Reforming the PBM Monopoly is critical to lowering prescription drug prices for Americans and providing more lower-cost drug options, like biosimilars. PBM middlemen also create waste and bureaucracy in the U.S. health care system. The Forum applauds the House Committee on Energy and Commerce for including reform provisions in its initial reconciliation package.  

“Reforming the PBM Monopoly would create a competitive free market dynamic that would support the long-term viability of the biosimilars industry. For years, PBMs have blocked patients from having access to lower-cost medicines. In fact, just this year, the FTC found that PBMs hiked the prices of specialty drugs by thousands of percent to generate $7.3 billion in revenue, which followed the GOP-led House Oversight Committee’s probe into PBMs’ anti-competitive business practices. PBMs prioritize their own profits over American patients.

“The Forum also appreciates the Trump Administration’s commitment to address out-of-control PBMs. In his May 12 press conference, President Trump directly called out PBMs and their anticompetitive conduct—proposing to cut them out of the prescription drug process This statement followed his Administration’s April 15 Executive Order requiring transparency from PBMs. We support the Trump Administration’s urgent action to lower drug costs for Americans by addressing the manipulative PBM practices that force higher costs onto patients.

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 Americans first, and PBMs are making patients pay more than they have to for medicines they need.

“Time is of the essence. Our industry faces a ‘biosimilars void’ in which more than 100 biologics are set to lose patent protection over the next decade—but only 12 have a biosimilar in development. U.S. biosimilar manufacturers spend 8 to 10 years and close to $300 million for each biosimilar they develop but need policies that remove convoluted incentives from PBMs that deny approved biosimilars from reaching patients. With this, the U.S. healthcare system could save an additional $189 billion, in addition to savings generated by biosimilars already on the market or expected to enter.

“The Forum and our members look forward to working closely both Congress and the Administration this pertinent issue. Americans need relief, and to give them relief, Congress must include PBM reform in the upcoming landmark reconciliation package.”

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

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