On Tuesday, Sen. Bill Cassidy (R-La.) hosted the Senate Health, Education, Labor, and Pensions Committee field hearing in Baton Rouge, La., on how Congress can make health care affordable for American families. NCPA member TJ Woodard, co-owner of Prescriptions to Geaux in Baton Rouge, testified as a witness. He was joined by Ronell Nolan, president and CEO of Health Agents for America; Debbie Rowell, owner of the Coffee Connection and Acadian Coffee Roasters; and Kathy Oubre, the CEO of Pontchartrain Cancer Center. The field hearing delved into the challenges in our current health system and ways that the witnesses experience them in their daily lives.
Woodard highlighted how PBMs negatively impact him and his wife's two stores, their daily workflow, and their patients. He called out vertical integration within the system, saying PBMs should not be able to dictate the terms by which other pharmacies must compete. He noted that when states push back against this vertical integration, as in Arkansas and now Tennessee, the PBM-insurers opt to close their pharmacies, prioritizing profit over patient access.
He highlighted how ERISA preemption is currently being used to back states into corners, arguing that ERISA should be modernized. Woodard also called out the issues surrounding Tricare, including the lack of audits on the management of the pharmacy contract held by Express Scripts, as well as the egregious up-charging ESI sends to the government while simultaneously under-reimbursing independent pharmacies filling Tricare beneficiary prescriptions.
There was a constructive conversation on how patients are impacted by the current health system and avenues to move forward. Oubre described how vertical consolidation in the marketplace has hurt her own cancer patients, requesting 340B transparency and that savings be passed to patients. She asked for Congress to continue further work on PBM reform, highlighting the case of a patient of hers who passed away after 35 days — before she was ever able to get her medication.
If you would like to watch the hearing, you can do so here.
