APCI Endorses the Drug Price Transparency in Medicaid Act

Author: APCI Staff/Tuesday, March 21, 2023/Categories: APCI News, Legislative Affairs

BESSEMER, Ala. — American Pharmacy Cooperative, Inc. (APCI) announced today that it heartily endorses the Drug Price Transparency in Medicaid Act, a bipartisan bill introduced in Congress last week that seeks to end significant pharmacy benefit manager (PBM) excesses affecting prescription drug pricing in Medicaid managed care.

APCI also commends Rep. Buddy Carter (R-GA) and the coalition of cosponsors from both sides of the aisle for their leadership and commitment to fighting PBM abuses in government-funded healthcare programs. In addition to Congressman Carter, the co-signers on the Drug Price Transparency in Medicaid Act are a bipartisan coalition of lawmakers consisting of Rep. Vicente Gonzalez (D-TX), House Republican Conference Chair Rep. Elise Stefanik (R-NY), Rep. Deborah Ross (D-NC), Rep. Rick Allen (R-GA), and Rep. Jake Auchincloss (D-MA).

For years, PBM practices in Medicaid managed care have obscured the true costs of prescription drugs, wasted hundreds of millions of taxpayers' dollars, and devastated community pharmacies by engaging in a practice known as spread pricing. In spread pricing, PBMs charge state Medicaid managed care programs more for prescription drugs than they reimburse pharmacies, allowing the PBMs to pocket the difference, or the "spread," as excess profit.

The Drug Price Transparency in Medicaid Act will put an end to spread pricing practices in Medicaid, saving taxpayer dollars while at the same time reimbursing pharmacies transparently and fairly while caring for state Medicaid patients across the country.

The bill also seeks to end PBM manipulation of prescription drug pricing by basing Medicaid prescription prices on the National Average Drug Acquisition Cost index (NADAC), an average of the prices paid by retail pharmacies for medications, rather than inflated "list prices" used by PBMs.

"This legislation is a win for taxpayers, patients, pharmacies, and advocates of transparency in the prescription drug marketplace," said APCI CEO Tim Hamrick. "We strongly encourage not only the independent pharmacy community but all stakeholders with an interest in controlling the ever-increasing cost of prescription drugs to rally in support of this critical legislation which represents a true fix to the problems plaguing drug pricing in Medicaid managed care."

"Large PBMs go out of their way to obscure the true costs of prescription drugs and to manipulate the system by engaging in practices like spread pricing," said Greg Reybold, APCI's Director of Healthcare Policy and General Counsel. "This legislation looks to put an end to those games by utilizing NADAC as the basis to reimburse pharmacies while paying pharmacies a fair dispensing fee to cover their costs to dispense."

APCI is committed to aggressively fighting for the passage of this legislation and calls on community pharmacists and other stakeholders to mobilize and support the passage of the Drug Price Transparency in Medicaid Act. This bill represents not only a fix to drug pricing in Medicaid managed care, but also a path forward for addressing drug pricing problems by utilizing NADAC in other federal healthcare programs, including Medicare Part D and Tricare.

About APCI

APCI is a member-owned cooperative of more than 1,600 member pharmacies in 30 states. Established in 1984 and headquartered in Bessemer, Ala., APCI is proud to lead the fight for prescription drug pricing transparency and reform.

You can view the original press release here.

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