[IMA-HelenT]

FULL RELEASE FROM THE IMA:

America’s Independent Doctors Call on HHS to Slash Drug Prices by Eliminating Cost-Driving Middlemen

“It’s time to make healthcare costs healthy again, and that starts by promoting transparency and removing the unnecessary hands from the pharmaceutical cookie jar.” – Dr. Kat Lindley

(Washington, DC) — The Independent Medical Alliance (IMA), a coalition of independent physicians dedicated to science-backed, patient-centered care, today called on the U.S. Department of Health and Human Services (HHS) to enact comprehensive prescription drug pricing reforms as part of the Trump Administration’s top-to-bottom review of HHS policies.

“This reform starts with one-hundred-percent price transparency,” said Dr. Kat Lindley, Director of IMA’s Fellowship Program. “That includes ensuring that any rebates and discounts are passed directly to the patient and not kept by PBMs or other middlemen.”

The IMA is urging HHS to consider a full list of drug pricing reforms, including:

– Mandating full transparency in PBM rebate and fee structures, banning spread pricing, and ensuring savings pass directly to patients.

– Reforming Wholesaler and GPO Practices: Require clear disclosure of markups and fees added by wholesalers and GPOs to prevent price gouging in the distribution chain.

– Promoting Direct-to-Consumer Models: Encourage manufacturers to offer transparent pricing directly to patients and pharmacies, bypassing intermediaries.

– Ensuring Insurer Accountability: Regulate insurer formulary designs to prioritize cost-effective medications and eliminate rebate-driven biases.

– Accelerating Generic Competition: Streamline FDA approvals for generic and biosimilar drugs to increase market competition and lower prices.

– Protecting Independent Pharmacies: Shield community pharmacies from anticompetitive practices by PBMs and wholesalers that threaten their sustainability.

“Middlemen across the supply chain are driving up prescription drug prices to unacceptable levels,” continued Dr. Lindley. “As the Make America Healthy Again effort continues its top-to-bottom review of HHS policies, we urge Secretary Kennedy and his team to dismantle the web of intermediaries and restore rational, transparent pharmaceutical pricing.”

Congressional hearings in 2024 detailed how intermediaries obscure pricing and increase costs. PBMs, which negotiate rebates and fees between manufacturers, pharmacies, and insurers, often retain significant profits, as noted in a 2023 Government Accountability Office (GAO) report. Wholesalers and GPOs, which control drug distribution and bulk purchasing, can add markups that further inflate prices. Additionally, insurers’ formulary practices sometimes prioritize higher-cost drugs tied to rebates over more affordable alternatives, leaving patients to bear the burden of inflated co-pays and deductibles.