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PhRMA president and CEO Stephen J. Ubl spoke recently at The Hill’s event, “Pathways to Patient Affordability.” He spotlighted patients’ affordability challenges, the unintended consequences we’re already seeing from the government price setting provisions in the Inflation Reduction Act (IRA) and how policymakers can address harmful pharmacy benefit manager (PBM) practices.

On the IRA, Ubl noted that the legislation does “a poor job of balancing continued incentives for innovation without lower costs for patients at the pharmacy counter.”

He went on to note the law failed to address the role of other actors in the health care system, like insurance companies and pharmacy benefit managers (PBMs), that ultimately determine what patients pay out of pocket for medicines.

“Three PBMs now control 80% of the market and they’re vertically integrated with health plans,” Ubl said. “They do play a role in restraining costs but there is very little evidence the fruits of their efforts are actually translating into lower costs for consumers.”

To help lower costs for people at the pharmacy, the discussion touched on several policy ideas, including protecting copay assistance that many patients rely on, making sure no patient has to pay more for their medicine than their health plan pays and demanding more accountability from PBMs.

The main message? Let’s try to address the parts of the IRA that are already harming biopharmaceutical innovation and make sure patients are not paying more for their medicines than their health plans or PBMs. Or as Ubl commented, “The system is broken. We have a system today that’s set up for patient pushers at the expense of patients, and we need to fix it.

Learn more here: PhRMA.org/Middlemen 

Emilie Signora

is a manager of public affairs at PhRMA focusing on the cost and value of medicines, as well as media executive visibility work. She previously worked for the U.S. Chamber of Commerce’s communications team. She received a B.A. in Communications from George Washington University. Outside of the office, Emilie enjoys traveling and spending time with her family.

Emilie Signora

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States should avoid repeating the IRA’s price‑setting mistakes 

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CMS undermines medical progress with MFN price controls 

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CMS puts patients and innovation at risk with MFN

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The IRA’s price setting doesn’t guarantee lower costs or better access

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CMS continues to make a bad law worse

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Foreign first pricing schemes don’t address why Americans pay more

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The unintended consequences of government price setting in Medicare Part D

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PhRMA reiterates concerns with IRA price setting program, urges CMS to mitigate harm

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More than 60 researchers advocate on Capitol Hill

July 1, 2024

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The IRA could lead to higher out-of-pocket costs for 3.5 million Medicare patients in 2026

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Alzheimer's & Brain Awareness Month: A conversation with Eisai

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ICYMI: The Opaque Industry Secretly Inflating Prices for Prescription Drugs

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Alzheimer's & Brain Awareness Month: A conversation with Eli Lilly and Company

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ICYMI: Health care policy should be driven by patients, not politics

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ICYMI: Misaligned policies undermine patient access

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PhRMA Warns Federal Agencies: Consolidation and vertical integration among insurers, PBMs, and hospitals threaten patients

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Women’s Health Month: A conversation with Astellas

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ICYMI: Innovation transforms lives but misguided federal policies threaten patient outcomes

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How the IRA is more coercive than any European government price setting scheme

May 29, 2024

Mental Health Awareness Month: Supporting loved ones and improving mental health in America

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How government price setting fails to address systemic health care inequities

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Women’s Health Month: A conversation with Sage

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Ongoing federal probes shed light on PBM and insurer practices

May 20, 2024

The use of real-world data in drug development

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Government price-setting boards: Why Minnesota needs to take a better approach

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Critics repeat same, misleading narrative on potential “costs” of new medicines

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WTAS: The consequences of consolidation and vertical integration

May 6, 2024

New analysis: Accelerated approval pathway is changing lives in underserved communities

April 30, 2024

IRA is already negatively impacting access to medicines in Part D

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Government price setting won’t help patients in Illinois

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Colorado is proof: Too many unanswered questions remain about state government price setting's impact on patients and providers

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What new cures would mean to families

March 7, 2024

Watch: A conversation with Dr. Mike Ybarra on Rare Disease Day

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American Heart Month: A nurse’s perspective

February 27, 2024

The truth about Nebraska's price setting push

February 13, 2024

Four years later, Maryland board still hasn’t delivered for patients

February 12, 2024

Proposed march-in framework would chill American innovation

February 7, 2024

Three things to know about antibody drug conjugates

February 2, 2024

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