Pharmacy benefit managers, which function as intermediaries between pharmacies and health insurers, are working on a proposal to voluntarily adjust some of their business operations in a bid to avoid fresh regulatory scrutiny from the Trump administration, Bloomberg News reported.
The PBM trade group Pharmaceutical Care Management Association has prepared draft proposals to bring to the attention of the Centers for Medicare and Medicaid Services ahead of potential new regulations against the industry, according to a document seen by Bloomberg News.
PCMA includes leading PBM operators such as CVS Health (NYSE:CVS), Cigna (NYSE:CI), UnitedHealth (NYSE:UNH), Elevance Health (NYSE:ELV), and Humana (HUM).
Among proposals cited in the report are plans to widen the availability of low-cost alternatives to biologics and increase payments to rural and independent pharmacies. A proposal to ensure that insured patients will not pay more than a pharmacy would charge someone without insurance is also under discussion.
To convince the CMS, PCMA is forwarding a range of ideas, including an argument to indicate that a well-publicized initiative will trigger favorable media coverage, according to the document.
The initiative comes as successive U.S. governments increasingly target PBMs for their role in driving up drug prices in the U.S. President Donald Trump issued an executive order in May calling on pharma companies to lower U.S. drug prices and pledging he will also “cut out” pharma middlemen from the sector.