WASHINGTON DC (April 2, 2019) — Senate Finance Committee Chairman Charles "Chuck" Grassley of Iowa and Ranking Member Ron Wyden of Oregon today sent letters to Cigna Corporation (Express Scripts), CVS Health Corporation, and Optum, the three leading pharmacy benefit-managers (PBMs), regarding their role in the skyrocketing cost of insulin in the United States.
Last month, the sens sent letters to Eli Lilly, Novo Nordisk, and Sanofi, the three largest insulin-manufacturers in the United States, kicking off their bipartisan investigation into insulin-prices.
In their letters today to the PBMs, the sens wrote, “while manufacturers set the list-price for insulin, pharmacy benefit-managers (PBMs) play a critical role in the pricing of insulin on which people living with diabetes depend… As the primary negotiators for government payers, commercial insurers, and individual employers, PBMs are in a unique position to leverage their size to lower drug-prices.”
“As consumers face rising bills at the pharmacy counter, it is unclear whether PBMs are appropriately leveraging their power for the benefit of taxpayers and patients, especially patients who take multiple or high-cost medications,” the sens continued.
The letters are seeking information and documents related to PBMs’ business-relationships with insulin manufacturers, public-insurance programs, and private-insurance plans, as well as pharmacies. The letters also seek information about how PBMs determine the size of rebates and which drugs are available on formularies. Finally, the sens seek information about the types of patient-health information that PBMs collect, evaluate, and maintain, and how that information is utilized and protected.
The Centers for Disease Control and Prevention (CDC) estimate that more than 30 million Americans have diabetes. On January 29, the Finance Committee held a hearing on drug pricing and witness Kathy Sego testified that her son, worried about the financial burden that the monthly $1,700 cost of insulin was having on his parents, began rationing treatment at the sacrifice of his health.
The Senate Finance Committee is tasked with oversight of Medicare and Medicaid, which are administered by the Centers for Medicare and Medicaid Services (CMS).
The letter to Cigna Corporation (Express Scripts) can be found HERE.
The letter to CVS Health Corporation can be found HERE.
The letter to Optum can be found HERE.
