Washington – The ERISA Industry Committee (ERIC) applauds the U.S. Department of Labor’s (DOL) final rule requiring pharmacy benefit managers (PBMs) to disclose how they are paid. By bringing rebates, discounts, and fees into the open, the rule gives employers a clearer view of what their health plans actually pay.
“We applaud the administration for advancing much needed transparency related to PBMs and affiliated entities. Large employers pay for their workers’ prescriptions, but many can’t see how much of that money their PBM and any affiliated entity keeps,” said James Gelfand, President and CEO of ERIC. “This rule changes that. Employers will be able to check the numbers, ask hard questions, and hold their vendors accountable to the contract. This rule will fill a critical gap in the legislation Congress passed earlier this year, for the first time giving employers a real view into so-called “spread pricing” arrangements and helping plan sponsors to improve the affordability of prescription drugs for working families.”
Among its recommendations to DOL in response to the rule when first proposed, ERIC urged adoption of a policy that would require any company that provides pharmacy benefit management services to a self-funded employer health benefits plan to show the “net effective cost” of every bid in a standard format, so employers can compare offers side by side. ERIC also urged DOL to ensure that plan sponsors would get true transparency into PBM-owned “drug branding entities” and specialty pharmacies.