This bill addresses some key issues regarding transparency in the outpatient prescription drug supply chain. However, it can be made better by including patients in the rebate pass-through provision.
May 16, 2023
The Honorable Bill Cassidy, M.D.
Senator for Louisiana
455 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Bernie Sanders
Senator for Vermont
332 Dirksen Senate Office Building
Washington, DC 20510
Dear Senator Cassidy and Senator Sanders,
As an organization representing over 2.1 million Americans who are age 50-plus, the Association of
Mature American Citizens is pleased to see that productive bipartisan conversations are
occurring throughout Congress regarding the transparency of pharmacy benefit manager (PBM) anti-competitive business practices.
Your bill, S. 1339, the Pharmacy Benefit Manager Reform Act, is certainly a step in the right direction. It
rightly bans spread pricing, where PBMs keep the price difference between what they charge health
plans and what they pay pharmacies for medications. It also bans PBMs from profiting from the practice
of “clawing back” the difference between patient co-pays and the cost of medications from the
pharmacy as well as other direct and indirect fees.
S. 1339 also requires the rebates received by PBMs from pharmaceutical manufacturers to be passed
through to plan sponsors and employers, but not to patients. AMAC has endorsed previous proposals
that shared these rebates with Medicare Part D recipients at the pharmacy counter as a means of
lowering out-of-pocket expenses. We fully believe that this bill may be improved for Americans who live
on fixed incomes during these excessive inflationary times. For this reason, we encourage you to include
a provision that favors patients in the rebate pass-through as a potential amendment in a final version of
Thank you, Senator Cassidy and Senator Sanders, for introducing bipartisan legislation that moves
towards transparency in the outpatient prescription drug supply chain. AMAC applauds your efforts and
offers our support for the Pharmacy Benefit Manager Reform Act.
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