How Will Proposed Legislation Affect PBMs Relations with Specialty Pharmacies?

Ron Lanton III, Esq, president, True North Political Solutions, LLC, discusses how proposed legislations would affect pharmacy benefit manager relations with specialty pharmacies.

Lanton: I think for DIR legislation, having something on the books is going to be great and it’s going to make the PBMs a lot more transparent.

What’s happened is that DIR has morphed into so many different things that nobody knows what DIR is anymore—it’s just whatever they say it is. So, I think having some parameters, especially in the congressional legislation out there. For people who don’t know that bill, it’s Senate Bill 413 and on the house side, it’s HR 1038. It’s a great piece of legislation to start with just addressing the DIR.

I know once you address that issue or if you want to do the clawback separate, either way is fine but at least having something on paper so the PBMs can actually say ‘okay these are the rules now and I can’t get around that foul line,’ will be a lot better for the industry.