A recent congressional hearing on the high cost of insulin may have helped bring bipartisan harmony to part of the House Energy and Commerce Committee.
Witnesses from pharmacy benefits managers (PBMs) and drug companies made at least some Republican lawmakers at the hearing so angry that the Republicans started talking about their common ground with the Democrats.
Rep. Earl “Buddy” Carter, R-Ga., pointed out that three of the PBM witnesses — Thomas Moriarty of CVS Health, Amy Bricker of Express Scripts, and Dr. Sumit Dutta of OptumRx — are affiliated with health insurer-PBM combinations.
(Related: Lilly Offers Half-Price Insulin)
CVS Health now owns Aetna Inc., Cigna Corp. now owns Express Scripts, and UnitedHealth Group Inc. owns OptumRx.
PBMs help health insurers, employer-sponsored health plans and other payers buy drugs. They negotiate the actual prices the clients’ pay with the drug makers and distributors.
Carter, who owns Carter’s Pharmacy Inc., said insurer-PBM integration gives PBMs an incentive keep the list price for a drug like insulin high, so that the PBM can send back a portion of the money back to the health insurer.
“Essentially,” Carter said, “you’re the PBM managing the money, and you’re sending the money back to another company that you own.”
Carter told the witnesses they had helped highlight the dangers of vertical integration.
“I want to congratulate all of you,” Carter said. “You’ve done something here today that we’ve been trying to do in Congress since the four years and three months that I’ve been here. And that is to create bipartisanship. Because, what you’ve witnessed here today is bipartisanship. What you have witnessed here today is bipartisanship. This is going to end. I have witnessed what you’ve done. I have seen what you have done with the PBMs.”
Carter said Republicans will help make sure that Centers for Medicare and Medicaid Services (CMS) Medicare drug plan price disclosure and rebate proposals take effect.
Carter and the witnesses appeared Wednesday at a hearing organized by the House Energy and Commerce Committee’s oversight subcommittee.
Rep. Diana DeGette, D-Colo., the subcommittee chair, smiled after Carter finished.
“I never thought I’d see the day when Buddy Carter was channeling Jan Schakowsky,” DeGette joked, referring to Rep. Janice Schakowsky, D-Ill., who is typically at odds with Carter during House hearings.
The oversight subcommittee held a another hearing on insulin prices a week earlier.