This Bipartisan Bill Would Lower Prescription Drug Costs
KEY POINTS
- The Modernizing and Ensuring PBM Accountability Act, or MEPA, would add transparency to the drug-price negotiating process.
- The Senate bill is likely to pass with bipartisan support and similar legislation was just introduced in the House.
- Regular consumers don't need to do anything to benefit if the bill passes, but contacting your representatives on issues that matter to you is always a good idea.
In the United States, prescription drugs are a half-trillion dollar industry. This may come as no surprise to some readers, given Americans spend over 2.5 times more on prescription drugs than residents of other high-income countries. Especially in today's inflation-driven economy, the rising price of prescriptions is putting serious strain on the personal finances of millions. Read on to learn more about why patients in one of the most advanced medical systems in the world are paying so much for drugs -- and what Washington is doing about it.
What is the MEPA bill?
One of the bills meant to lower drug costs is the Modernizing and Ensuring PBM Accountability Act (MEPA), which is progressing through the Senate. This bipartisan legislation doesn't actually go after drug manufacturers, but instead targets middlemen known as pharmacy benefit managers or PBMs.
Most employer-sponsored health insurance and government programs contract a PBM to negotiate prescription drug prices on their behalf. However, only three pharmacy benefit managers control about 90% of the market, and they are not subject to strict oversight or transparency requirements. This means that many Americans and their employers are left in the dark about how PBMs are negotiating, and whether they are actually getting a good deal on prescription prices.
MEPA would change that, largely by adding additional reporting and auditing requirements to PBMs. In its current form, the bill mainly focuses on PBMs serving Medicare Part D recipients. But lawmakers appear to have an appetite for extending such accountability measures to some 160 million Americans covered by employer-sponsored health insurance.
Will it pass?
The ultimate fate of MEPA is not guaranteed, but it is gradually making its way through the Senate. Meanwhile, members of the House of Representatives have put forth a similar proposal that has garnered strong support. The bills must be reconciled before they can be passed into law, but it is likely that lawmakers will be able to find common ground.
MEPA passed through the Senate Committee on Finance late last month, with nearly unanimous support from a closely split body of senators. The proposal may include additional mark-ups before being passed by the Senate, but wide support in the testing ground of the Finance Committee bodes well for the bill.
Similar legislation was introduced in the House in the form of the Better Deals and Lower Prices Act by Representative Arrington, a Texas Republican. The bill was touted by the House Ways and Means Committee Chairman Jason Smith (R-MO), and is expected to gain the approval of others on the committee. If both the Senate and the House can agree on final wording of the bill, it is likely to pass in what has otherwise been a largely gridlocked Congress.
What should you do?
If the bill passes, individual Americans will not need to take any action to benefit from lower drug prices. Thanks to greater transparency, those covered by employer-sponsored health insurance or Medicare Part D may see lower costs the next time they visit the pharmacy.
In the meantime, supporters of prescription drug transparency bills may consider getting in touch with their Congressional representatives. Constituents' opinions inform policy decisions, and a quick email or call to your senators or representative is a great way to share your thoughts.
One factor in rising prescription drug costs is a lack of accountability within healthcare administration. Two bills in Congress would target drug price negotiating middlemen and require greater transparency for insurance providers. Proponents of such legislation may consider expressing their support to their representatives -- after all, like personal finances, civic engagement is not a spectator sport.
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