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More activity on the Hill yesterday on PBMs—catch up below. And no, you’re not imagining that there are more mosquitoes—here’s why that’s a problem. (599 words, 2 minutes, 59 seconds) |
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PBM bills advance in House and Senate |
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House and Senate Committees yesterday passed legislation to control the way pharmacy benefit managers (PBMs) can profit by increasing drug prices—here are the details.
Why it matters: PBMs manage prescription drug benefits for insurers and payers, with three PBMs controlling 80% of all U.S. prescriptions. PBMs receive rebates from drug makers, and should pass savings on to patients—but research shows they often profit while making drugs costlier.
In the Senate: The Modernizing and Ensuring PBM Accountability (MEPA) Act, introduced by Committee Chair Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID), passed the Senate Finance Committee by a bipartisan vote of 29-1.
The bill would: - prohibit PBMs in the Medicare Part D program from deriving compensation based on a manufacturer’s list price;
- reform pharmacy reimbursement in Medicare Part D and prevent “spread pricing;” and,
- require a report by the Health and Human Services Inspector General about the price impact of vertical integration of Part D plans, PBMs, and pharmacies.
In the House: The House Ways and Means Committee approved the Health Care Price Transparency Act of 2023 (H.R. 4822) along party lines.
The bill would require transparency for insurers and PBMs, giving patients and employers knowledge they need to stimulate competition and lower prices, Chair Jason Smith (R-MO) said. In the weeds: Democrats objected to the lack of controls on Medicare Advantage plans and private-equity-owned healthcare organizations, though these controls passed with bipartisan support in the House Energy & Commerce Committee. Reps. Lloyd Doggett (D-TX), Earl Blumenauer (D-OR), and others raised objections, but Democrats’ amendments failed. Defending the omission, Chair Smith said the committee did not have time to discover appropriate Medicare Advantage transparency measures that do not harm the system.
What’s next: We expect Congress to push forward on PBM legislation this fall.
Want to know more about how PBMs work? Go inside the drug pricing loop. |
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How changing weather is enabling the spread of disease |
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The current heat wave’s health toll is well known, but long-term changing weather patterns are also driving the rapid spread of diseases in the United States.
The “world’s deadliest animal,” the mosquito, which carries a multitude of diseases, is expanding its season and range in the U.S. due to warming, says The Washington Post—and we saw the first locally transmitted malaria in the U.S. in 20 years.
And other disease-carrying parasites, like ticks and fleas, are flourishing in warmer U.S. temperatures, per the AP.
Bird flu spreads faster, jumping to mammals more easily because of rising seas and other climate impacts, Grist reports.
In high water: While monsoon flooding drives cholera in parts of South Asia with poor sanitary infrastructure, in the Western U.S., increased rain is spreading the range of the fungus that causes valley fever.
Biotech is responding—including with gene editing to control mosquito and tick populations and to produce birds resistant to bird flu.
Ultimately, we all need to cooperate to control climate change. Biotech can be a part of the solution, decarbonizing air travel with sustainable aviation fuel, reducing carbon emissions in agriculture and manufacturing, and helping capture more carbon. |
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