Employer-sponsored coverage is the largest source of private health insurance in the United States, providing coverage to more than 150 million people. As a result, employers bear a significant portion of America’s prescription drug costs, making the rising price of medications one of the most pressing challenges facing America’s large employers.
On Wednesday, February 11, ERIC’s President & CEO James Gelfand shared the challenges facing employers, workers, and their families when he testified at the U.S. House of Representatives Energy and Commerce Committee’s Subcommittee on Health’s hearing titled “Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain.” During his testimony, Gelfand praised commonsense policy solutions recently advanced by Congress and the administration to reform anti-competitive practices of Pharmacy Benefit Managers (PBMs) and stressed the need for further action to make sure employers are getting the best deal on medications for their workers.
Gelfand also outlined several root drivers inflating prescription drug costs and offered policy solutions to make affordable prescription drugs more accessible. He urged action on several bills to address limited competition, gamesmanship and abusive practices including:
- Biosimilar Red Tape Elimination Act (H.R. 5526): The bill removes certain requirements for biosimilars to be designated as interchangeable. Specifically, it establishes a presumption that an approved biosimilar is interchangeable with the reference product without the need for additional evidence from the manufacturer and removes the applicable exclusivity periods for a first interchangeable biosimilar.
- Patients Deserve Price Tags Act (H.R. 5582): The bill provides for improved price transparency, helping patients understand the actual cost of care, and extends reporting requirements across a range of health care providers, plans, and PBMs.
- Healthy Competition for Better Care Act (H.R. 6248): The bill improves fairness in contracting by allowing for enrollee incentives to choose high-quality and low-cost providers and insurers, and employers to contract with hospitals and providers without requirements to enter into additional contracts with other affiliated providers or hospitals.
- PBM Fiduciary Accountability Integrity, and Reform (FAIR) Act (H.R. 6837): The bill clarifies that fiduciary standards for employer health benefit plans governed by the Employee Retirement Income Security Act (ERISA) apply in full to PBMs performing services on behalf of the plan. ERIC has long advocated that Congress enact strong PBM transparency and accountability reforms to provide relief for employers and workers nationwide.
James’ testimony allowed ERIC an opportunity to engage directly with policymakers on the issues that matter most to our organization when addressing the rising costs of prescription drugs. ERIC will continue to be a part of the conversation and the voice of large employers on Capitol Hill.
Read James’ entire testimony HERE.