Share the Savings with Seniors Act Would Ensure Patients with Chronic Conditions Benefit from Savings
WASHINGTON, D.C. – July 31, 2023 – U.S. Senator Sherrod Brown (D-OH) introduced bipartisan legislation to lower out-of-pocket costs of medicines for chronic conditions in the deductible or when patients owe coinsurance. The Share the Savings with Seniors Act would require pharmacy benefit managers (PBMs) and insurers to pass on all savings they negotiate on the list price of a chronic condition drug to the patient to lower the cost of their drug at the pharmacy counter. Brown introduced the bill with John Cornyn (R-TX), Tom Carper (D-DE), and Thom Tillis (R-NC).
“Because of corporate greed, prescription drugs are some of the most overpriced goods many Ohio families are forced to pay for each month,” said Brown. “Our bill will help lower costs for patients with chronic conditions by allowing patients to share in the savings that result from deals cut between Big PhRMA and corporate middlemen.”
PBMs are third-party administrators that are hired by health insurance plans to negotiate for rebates and other price concessions, decide which medications go on the preferred drug list, and establish pharmacy networks.
PBMs and insurers negotiate with drug manufacturers to bring down the list price of certain medications. However, with medications that require a co-payment from a patient, many PBMs and insurers require that patients pay their share of the co-payment based on the full list price of the drug, rather than the lower price that the PBM or insurer negotiated for themselves. This means that patients can end up paying more for their medication than their insurer did. The Share the Savings with Seniors Act would require the full rebate negotiated by PBMs to be passed on to patients who owe a copayment on chronic medicines, leading to direct savings for patients at the pharmacy counter.
On Monday, Brown introduced the Strengthening Pharmacy Access for Seniors Act to provide more transparency in the prescription drug supply chain and provide Seniors with more choices to fill their prescriptions. In March, Brown pushed for reform of PBM practices that lead to high drug prices for patients and high fees for Ohio pharmacies. Brown has fought to pass his bipartisan Pharmacy DIR Reform to Reduce Senior Drug Costs Act which would ensure that all pharmacy price concessions are assessed at the point of sale and eliminate the retroactive nature DIR clawback fees imposed by PBMs. Sections of Brown’s bill on DIR reform and to lower costs for older Ohioans were included in legislation passed out of the Senate Finance Committee on July 26, 2023.
Brown has long been a leader in standing up to Big Pharma and working to lower prescription drug prices and improve access to health care for Ohioans. Because of the Inflation Reduction Act, manufacturers are now required to pay a rebate to Medicare if a drug’s price increase exceeds the rate of inflation. Brown secured a critical provision in the law allowing the Secretary of HHS to negotiate directly to lower the price of prescription drugs for Medicare beneficiaries to ensure older Americans get the best possible deal on high-cost medications. The legislation also includes a monthly $35 cap on out-of-pocket insulin costs for all Ohioans on Medicare who rely on insulin to stay healthy.