The EACH/PIC Coalition submitted comments to the Oregon PDAB in advance of their September meeting on policies proposed for the annual report to the Oregon legislature. The letter applauded the board for considering PBM reforms and urged consideration of patient-driven policies.
The letter stated:
“We applaud the inclusion of reform proposals that would hold pharmacy benefit managers (PBMs) accountable for their role in driving up drug costs. Specifically, we strongly endorse the elimination of spread pricing, the delinking of PBM compensation from drug prices, and requirements for increased transparency.”
“Eliminating spread pricing, requiring rebates and savings to be shared with patients, and increasing transparency into PBM practices will directly address these patient-reported problems. Such reforms are essential to ensure affordability policies actually result in lower costs at the counter, not just on paper.”
“Equally important is ensuring that reimbursement rates and dispensing fees reflect the true costs of dispensing medications. Pharmacies and physician practices should not be forced to operate at a loss to provide care. If reimbursement is set below cost, many providers, especially smaller or independent practices, will face unsustainable financial pressure. This risks reduced access to care, particularly in rural and underserved communities, and could lead to disruptions in treatment continuity for vulnerable patients.”
“Finally, while we are encouraged that the recommended policies include a range of potential solutions, we continue to emphasize that UPLs are the wrong approach. As our coalition has consistently noted, UPLs cap what insurers and the state pay, not what patients pay. Patients may see no benefit of UPLs. Worse, insurers and PBMs may respond with higher cost-sharing, formulary reshuffling, or new utilization management requirements. These responses can lead to delays, disruptions, and even non-medical switching of stable therapies, with serious consequences for patient health.”