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PBMs, big pharma under attack in Utah Legislature

File -- Representative Paul Ray, (PHOTO: KSL TV)

SALT LAKE CITY, Utah — The spotlight was squarely on big pharma and third-party administrators in a Utah Legislature subcommittee meeting Tuesday.

The conversation was happening in the Social Services Appropriations Subcommittee. They’re responsible for reviewing the budgets of the Departments of Health, Human Services and Workforce Services.

Big pharma, big business

On their agenda was hearing a performance audit of Public Employees Health Plan’s Pharmacy Benefit Managers, or PBMs.

House Chair of the subcommittee, Representative Paul Ray, quickly went on the attack in defense of local business.

“I see CVS, you’re trying to push local pharmacies in my district out of business,” he explains. “You’re trying to push them out.”

According to him, these companies are dictating market price and purposely rising prices in order to pocket more money.

“You’re telling them, we will not buy any drugs from you if you don’t increase your price,” says Representative Ray. “So we can increase the rebate.”

Lobbying for change

The price gouging on a number of medications has long been a national issue and is now coming under scrutiny at the state capitol.

Representative Norm Thurston is planning to introduce a number of bills in the general session, because he also has stated the need for lower prices and increased transparency.

“I talked to one manufacturer in insulin last year and they wanted to decrease their price, but they were being forced into [an] increase by their PBM,” explains Representative Ray.

At least once during the presentation, Ryan stopped the proceedings to interject his general disgust.

“I’m looking at this [and] what I’m seeing is this is some pretty lipstick on a pig,” he says.

He added that legislation would be coming out this week to address some of the issues, but didn’t get into specifics.

The subcommittee later discussed the federal government’s proposed Medicaid financing reforms and reviewed the Department of Health’s Medicaid Services Budget.

Included in that was a report on recommendations for Medicaid compensation for caregivers.