AT PINE PLAINS PHARMACY, CONGRESSMAN RYAN CONTINUES PUSH TO BRING DOWN PRESCRIPTION DRUG COSTS, DEMANDS SPEAKER JOHNSON INCLUDE LANDMARK DRUG PRICING REFORM IN NEXT MONTH’S GOVERNMENT FUNDING BILL
At Pine Plains Pharmacy, Congressman Ryan Continues Push to Bring Down Prescription Drug Costs, Demands Speaker Johnson Include Landmark Drug Pricing Reform in Next Month’s Government Funding Bill
Pharmacy benefit managers (PBMs) are middlemen between insurers and pharmaceutical companies and the key negotiators of drug prices; the three largest PBMs control 80% of the prescription drug market and take in over $450 billion in revenue
Speaker Mike Johnson removed PBM reform, which would have lowered prescription drug costs and protected small local pharmacies, from the last government funding package despite broad bipartisan support
PINE PLAINS, NY – Today, at Pine Plains Pharmacy, Congressman Pat Ryan continued his push to bring down prescription drug costs. Joined by pharmacists from across the Hudson Valley, Ryan demanded Speaker Johnson include landmark drug pricing reforms in next month’s government funding package. These reforms, including Congressman Ryan’s Pharmacists Fight Back Act and the Drug Price Transparency in Medicaid Act, would lower prescription drug costs and help keep local pharmacies in business. This legislation, which has wide bipartisan support, was initially included in December’s government funding bill before Speaker Johnson removed it at the last minute due to significant pressure from multi-billion dollar health care corporations. The three largest PBMs control 80% of the prescription drug market and take in over $450 billion in revenue.
PBMs are middlemen between insurers and pharmaceutical companies and the key negotiators of drug prices. PBMs have ultimate discretion, and will often mark up drug prices to maximize their own profits, withholding savings from consumers. They also systematically reimburse pharmacies less than their cost to buy and sell medication. This has led to mass closures of local, small, family owned pharmacies like Nasir’s in Pine Plains.
“PBMs are gouging Hudson Valley families and driving our small businesses into bankruptcy. We have bipartisan legislation ready to go that would bring down costs AND help our local pharmacies survive. I’m demanding Speaker Johnson have the courage to stand with the American people and against the Big Pharma companies ripping us all off,” said Congressman Pat Ryan. “We’re all feeling the pressure of prices that are still too high – this legislation would provide immediate relief. For far too long, health care monopolies have had more than enough power and profit – we need to put Hudson Valley families first.”
“Congress missed the chance to include this legislation in the last CR, and we should not let it happen this March,” said Nasir Mahmood, owner of Pine Plains Pharmacy. “PBM transparency will bring billions in savings to consumers, employers and the government while giving them more choices to fill their prescription needs at their local pharmacies. I am thankful to Congressman Ryan to take this initiative as he has been a friend of independent pharmacies and small businesses.”
“The PBM industry, dominated by 3 major players which control 80% of the prescriptions in the US, is in serious need of reform and federal oversight,” said Al Squitieri, owner of Slate Hill Pharmacy. “Camouflaged by the complicated, complex & convoluted business model they themselves created, PBMs have escaped scrutiny and needed regulation. We endorse the significant bipartisan support that exists for federal legislation to rein in this costly “middleman” of the US healthcare system. We thank our Congressman Pat Ryan for his unwavering support on these issues. With his help we can make healthcare better for all.”
“Independent pharmacies are closing at the rate of one per day because of the predatory behavior of Pharmacy Benefit Managers (PBMs),” said Douglas Hoey, CEO of the National Community Pharmacists Association (NCPA). “Patients are losing access to local pharmacies, especially in rural and underserved areas. Not only are small business pharmacies being hurt, but the cost of prescription drugs has risen dramatically under the so-called management of PBMs, which are owned by big insurance companies. There is bipartisan support in Congress for reform, thanks to champions like Representative Ryan. And there is no more time to waste. PBM reform must be enacted this year, or many more independent pharmacies will disappear, prescription costs will continue to rise, and millions more patients will be stranded without a local pharmacy.”
“Our local independent pharmacies are truly essential service providers, especially in our largely rural Hudson Valley communities. They know our families and our medical histories. Often family-owned, they are vital small businesses that provide jobs for all ages and boost the local economy, as well as filling a critical healthcare need,” said Assemblymember Didi Barrett. “I thank Congressman Ryan for his support of meaningful PBM reform, and appreciate his partnership in protecting our local pharmacies from unfair practices and price gouging.”
Over the past decade, pharmacy benefit managers (PBMs) — the middlemen between pharmacies and insurance companies — have morphed into large healthcare conglomerates that exercise control over every link in the prescription drug delivery chain. Today, the largest healthcare conglomerates each own a PBM — which pays for pharmacy services — as well as the pharmacy chains that provide those services. This inherent conflict of interest results in higher drug costs for patients and fewer independent pharmacies, but bigger profits for the corporate healthcare giants.
Congressman Ryan is a cosponsor of the Drug Price Transparency in Medicaid Act, which would prohibit PBMs from charging Medicaid more than they paid pharmacies for a drug. He also coleads the Pharmacists Fight Back Act, comprehensive legislation to require adequate reimbursements to pharmacists, prohibit PBMs from steering patients to their own pharmacies, and eliminate PBM restrictions on patient choice. Large portions of these bills were set to be included in the December government funding legislation until they were removed at the last minute.
Throughout his time in office, Congressman Ryan has always emphasized the importance of lowering costs, specifically when it comes to health care. He supports landmark legislation which has already lowered the prices of ten of the most common high-cost pharmaceuticals, fought to lower premiums for 20 million Americans receiving healthcare through the Affordable Care Act, and secured more than $2 million to expand services at Sun River Health in Beacon.
Congressman Ryan also recently reintroduced the Stopping Pharma’s Ripoffs and Drug Savings for All Act, as a part of his broader Affordability Agenda; the Congressman’s first legislation of the 119th Congress which aims to lower costs across the board. The Stopping Pharma’s Ripoffs Act would rein in Big Pharma’s current abuse of U.S. patent law, and make it easier to produce less-costly generic drug alternatives.
A copy of Ryan’s letter to Speaker Mike Johnson appears below:
Dear Speaker Johnson,
I write to urge you to include reforms to lower prescription drug costs and protect community pharmacies in any upcoming government funding bill. Congress must take immediate action to protect Americans who are getting ripped off by Pharmacy Benefit Managers (PBMs), the corporate middlemen who control the vast majority of prescription drugs.
As you know, major bipartisan reforms to PBMs were stripped from the continuing resolution that passed the House on December 20, 2024, after Elon Musk and PBM lobbyists torpedoed the agreement. These policies would crack down on abusive PBM practices that are raising drug costs for patients and driving independent pharmacies out of business. As the House approaches the government funding deadline on March 14, I’m demanding that any spending package prioritize PBM reform.
PBMs purchase prescription drugs on behalf of insurance plans, including Medicare Part D and many Medicaid plans. Currently, the three largest PBMs control 80% of the prescription drug market and take in over $450 billion in annual revenue. While the stated mission of PBMs is to save money for patients, they’ve instead used their market power to drive drug costs higher, underpay independent pharmacists, and enrich their affiliated pharmacies and insurance companies. One example is the practice of “spread pricing,” whereby PBMs charge insurers and patients a higher price than that which it paid a pharmacy for a drug. These tactics have cost patients and taxpayers billions of dollars and forced many independent pharmacies to the point of closure.
To address these abuses, Democrats and Republicans came together on a package of PBM reforms to be included in the December continuing resolution. Yet at the last minute, Elon Musk publicly came out against the agreement, and Republican leadership stripped the PBM provisions from the bill. Among these were provisions to ban spread pricing in Medicaid, ensure pharmacies are reimbursed at a fair rate, prevent PBMs from profiting from higher priced drugs in Medicare, and increase transparency regarding PBM operations. If enacted, these reforms would save taxpayers nearly $5 billion.
My constituents are facing tremendous pressure every day that Congress does not act on PBM reform. These reforms have broad, bipartisan support and would provide immediate relief both for Americans who rely on lifesaving medications, and for the small pharmacies that are often the backbone of their communities. It’s well past time – I urge you to ignore the PBM lobbyists and get this done.
Thank you for your attention to this request.
Sincerely,
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