PBM Compensation 'Delinked' From List Price, Utilization In Medicare Part D Under Senate Bill

Legislation focuses on key aspect of Senate Finance Committee framework for reforming pharmacy benefit managers, reflecting concerns that current compensation practices reward PBMs for higher list prices and increase costs for patients. It does not take direct aim at rebates.

Why Are PBM Fees Based On A Drug's List Price? • Source: Shutterstock

Pharmacy benefit managers would be prohibited from accepting compensation based on the price or utilization of a drug as a condition of entering into a contract with a Medicare Part D plan, under a bill announced by the Senate Finance Committee on 14 June.

Separating compensation from price and utilization aims to address concerns that current practices encourage higher list prices and disadvantage patients whose cost sharing is based on the list price rather than the net

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