Increased Transparency in Drug Pricing and Pharmacy Benefit Manager Services
New rules enhance oversight of Pharmacy Benefit Managers (PBMs), requiring them to disclose detailed information about drug costs and rebates. This aims to help health plans and insurers better understand spending, potentially leading to lower drug costs for citizens.
Key points
Pharmacy Benefit Managers (PBMs) must disclose detailed data on drug prices, manufacturer rebates, and fees to health plans and insurers.
Reports will include information on patients' total out-of-pocket spending for drugs, including co-payments, co-insurance, and deductibles.
Financial penalties are introduced for PBMs failing to disclose required information or providing false data, ensuring compliance with new regulations.
The act mandates a Government Accountability Office (GAO) study on pharmacy networks and their ownership ties to PBMs, to assess impact on patient pharmacy choice and drug prices.
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