{"id":243150,"date":"2025-05-15T12:25:47","date_gmt":"2025-05-15T12:25:47","guid":{"rendered":"https:\/\/peraltafinancing.com\/alabama\/sen-britt-challenges-current-pharmacy-benefit-structure\/"},"modified":"2025-05-15T12:25:47","modified_gmt":"2025-05-15T12:25:47","slug":"sen-britt-challenges-current-pharmacy-benefit-structure","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=243150","title":{"rendered":"Sen. Britt challenges current pharmacy benefit structure"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<p class=\"p1\"><span class=\"s1\">U.S. Sen. Katie Britt, R-Alabama, attended a Senate Judiciary Committee <a href=\"https:\/\/www.youtube.com\/watch?v=6yJfGOEEkEg\"><span class=\"s2\">hearing<\/span><\/a> entitled \u201cPBM Power Play: Examining Competition Issues in the Prescription Drug Supply Chain\u201d to examine the role of pharmacy benefit managers. She heard from a number of witnesses, including Dr. Randy McDonough, cofounder and owner of Towncrest Pharmacy; Dr. Neeraj Sood, a professor at the University of Southern California\u2019s Price School of Public Policy; and Dr. Sheetal Kircher, an associate professor at Northwestern University\u2019s Feinberg School of Medicine.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Britt began her opening statement by lamenting closures of independent pharmacies, stating, \u201c\u2026 in Alabama, we looked at the reliable data between [2018 and 2025] \u2013 we had over 225 closed doors\u2026 a rate of about one per month. When you\u2019re dealing with a state like Alabama, when in our rural communities, local independent pharmacies [are] often the only health care provider within 20 or 30 miles, this is absolutely, completely unacceptable.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cWhen PBMs impose retroactive clawbacks, DIR fees, and below-cost reimbursement rates, they\u2019re not just squeezing your bottom line, they are pushing out entire communities towards pharmacy deserts,\u201d the senator continued. \u201cAre current PBM practices accelerating the loss of rural pharmacies? And what does that mean for basic access to medications and clinical services in places like rural Alabama?\u201d she asked.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Dr. McDonough responded affirmatively that PBM practices are accelerating the closures of rural pharmacies, saying,\u00a0\u201cI\u2019ve also seen how community pharmacies, when they close up, how the community misses them because they may be the only health care provider, as you said, that they have access to. And these are not just community pharmacies. These are people who are trusted within the community, who contribute back to the community. These are the people who get the calls after hours. And actually, if you take a drug to a patient at their home, that\u2019s what\u2019s missing. And we\u2019re going to be losing more and more.\u201d<\/span><\/p>\n<p class=\"p5\"><span class=\"s1\">Senator Britt agreed, saying, \u201cThere is a relationship aspect in our rural communities that cannot be matched. When you\u2019re looking at creating opportunity, that opportunity for the American Dream, you can\u2019t draw in that opportunity without access to care, without access to pharmacies. No one is going to come and locate a plant and create good paying jobs, or decide to expand in a place that has a pharmacy desert\u2026 looking at this in a place like Alabama, where 55 out of 67 of our communities are rural communities, they deserve better.\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">She continued her line of questioning: \u201cAs the PBM debate rolls on, I\u2019m struck by how the patient and employers, the ones who are actually paying the bills, seem to be the least empowered voices in the entire system. Employer-sponsored health care insurance remains the primary source of health coverage in America, so more than 164 million Americans obtain coverage through an employer. \u2026 Why do most employers accept a model where intermediaries are incentivized by the size of the rebate, rather than the value of the drug to the patient?\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">Dr. Sood responded to Senator Britt\u2019s question, saying, \u201cI think the challenge is employers don\u2019t have a lot of choice. 80 percent of the market is controlled by the big three PBMs. \u2026 That scale is important in leveraging, our discount from manufacturers, but I think employers would prefer a model where there was a direct price reduction and no rebates, because then I can make sure that I\u2019ve got the money.\u201d<\/span><\/p>\n<div class=\"code-block code-block-6\" style=\"margin: 8px auto; text-align: center; display: block; clear: both;\">\n<div class=\"zox-post-ad-wrap\"><span class=\"zox-ad-label\">Advertisement. Scroll to continue reading.<\/span><\/div>\n<\/div>\n<p class=\"p1\"><span class=\"s1\">\u201cWhat else do you think is needed for more visibility, bargaining power, and value for our dollar?\u201d Britt asked.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cWhat is needed is greater transparency so that we know, or employers can know, whether they\u2019re getting a good deal or not. And we need a fiduciary responsibility for PBMs that if they don\u2019t act in the best interest of plan members or employees, we can address that in the courts,\u201d\u00a0Dr. Sood responded.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">In her final line of questioning, the Senator asked Dr. Kircher if she believed that\u00a0\u201crebate-driven formula design and utilization tools reflect sound clinical judgment?\u201d<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">\u201cOftentimes, no. Oftentimes, we are trying to fight for medications that are nationally guideline accepted that we are still fighting for,\u201d\u00a0Dr. Kircher responded.<\/span><\/p>\n<p><!-- CONTENT END 1 -->\n\t\t\t<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>U.S. Sen. Katie Britt, R-Alabama, attended a Senate Judiciary Committee hearing entitled \u201cPBM Power Play: Examining Competition Issues in the Prescription Drug Supply Chain\u201d to examine the role of pharmacy benefit managers. She heard from a number of witnesses, including Dr. Randy McDonough, cofounder and owner of Towncrest Pharmacy; Dr. Neeraj Sood, a professor at [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":243151,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11763],"tags":[13716,15708,11117,11089,4391,34271,46490,24871,10191,14320],"dealstore":[],"offerexpiration":[],"class_list":["post-243150","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alabama","tag-benefit","tag-britt","tag-challenges","tag-current","tag-healthcare","tag-pharmacy","tag-pharmacy-benefit-managers","tag-sen-katie-britt","tag-sen","tag-structure"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Sen. Britt challenges current pharmacy benefit structure - Som2ny Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fivemor.com\/?p=243150\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sen. Britt challenges current pharmacy benefit structure - Som2ny Network\" \/>\n<meta property=\"og:description\" content=\"U.S. Sen. Katie Britt, R-Alabama, attended a Senate Judiciary Committee hearing entitled \u201cPBM Power Play: Examining Competition Issues in the Prescription Drug Supply Chain\u201d to examine the role of pharmacy benefit managers. 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