$$$ from PBMs, GPOs, and Pharma Flooding into the US Congress DC Swamp

Desperate to preserve the status quo, PBMs and Pharma are flooding the swamp with dollars to buy the votes of policymakers.

Beverly Gossage of hsabenefitsconsulting.com sends in this intel from MorningConsult.com:

  • In the first quarter of 2019, the trade group representing pharmacy benefit managers, the Pharmaceutical Care Management Association, spent $1.49 million on lobbying, breaking its previous spending records for a three-month span, as pharmacy benefit managers fight a proposal from the Trump administration that would fundamentally alter the current rebate system. The pharmaceutical company trade group, PhRMA, spent $9.91 million during the quarter.

Dr. Marion Mass notes that the “1.4 million spent by PBM‘s in the first quarter represents three large companies mostly. That’s about a half 1 million for company… The trade group Pharma Represents approximately 35 companies… While it’s a lot to spend a quarter of a million dollars per company, it’s half the amount per company that the PBMs are spending.

Don’t forget the lobbying dollars, reminds Dr. Mass, that Group Purchasing Organizations, (PBMs’ cousins that manage medical supplies and drugs in hospitals) are lavishing on Congress to keep their kickback dollars flowing:

Just two examples of  GPO lobbying efforts include:

Vizient, Inc.:



Premier, Inc.:



The propaganda and bribes from the PBMs and GPOs may be losing their effect as more and more members of Congress are waking up to the reality that middlemen are harming patients by driving up costs, in often hidden ways, without adding any corresponding benefits.

Senator John Cornyn, writes: “One family from the Dallas area told me they struggle to pay for their nine-year-old son’s insulin, which must be filled in a three-month supply, and costs $1,200. … Finding the culprit behind these increasing prices isn’t easy…. Part of the reason it’s so complex is because of the pharmacy benefit managers who negotiate prices with manufacturers. The rebates they provide should lower the price for patients, but the terms of these rebates, including dollar amounts and incentives, are often cloaked in secrecy, making it nearly impossible to follow the money. This lack of transparency for the consumer is alarming, and it’s clear that without action, the problem will only get worse.”


[Sen. Cassidy is pictured in the above Tweet helpfully exposing the magnitude and growth of revenue retained by PBMs.  Will he be as outspoken about ending the graft by GPOs given that he is the top recipient of contributions connected to Premier, Inc. the GPO for 76 percent of U.S. community hospitals?

It is past time to excise the middlemen! One big step in the right direction would be to ensure that middlemen stop pocketing kickbacks disguised as rebates. Any discounts should be passed through directly to patients. And administrative fees paid to the middlemen must not be tied to list prices gamed to earn the biggest payment.

Here’s how to start unwinding the perverse incentives:

Help be a part of the solution. Learn more at: http://nomiddlemen.org.

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