It didn’t take long for those of us at the ERISA Industry Committee (ERIC) to recognize that ERIC and GTMRx are philosophically aligned.
We share many goals; it ultimately comes down to driving adoption of patient-friendly improvements—including comprehensive medication management (CMM
)—by focusing on the operations of group health plans and PBMs. This isn’t merely aspirational: It involves working together to improve the laws and regulations that govern these entities and relationships to improve care for patients.
GTMRx’s mission is to drive visibility for how all stakeholders in health care can evolve to ensure medications are managed safely, effectively, affordably and that the right medication is available to the consumer. By partnering with ERIC, the leading advocate for large employer plan sponsors, GTMRx broadens its reach to employers and gets critical support for turning good ideas into good policy.
Our partnership began in June, and it’s already bearing fruit.
Bipartisan calls for transparency
As I’m writing this (Wednesday afternoon, June 22), the House is preparing to pass HR 7666. The legislation makes vast strides in improving the mental health system for patients, and—with the addition of new language—it includes provisions requiring transparency in drug costs for employers. This change is a result of input from various stakeholders, including ERIC and GTMRx. Our next step is to ensure the language also appears in the Senate version of the bill.
We’ve had some other early wins:
- Request for GAO report: Three GOP leaders sent a letter to the U.S. Comptroller asking the GAO perform a study on the role of PBMs in the pharmaceutical supply chain. We’re particularly interested in the degree to which fiduciary responsibility might improve patient care. The inquiry will take time, but the request represents a huge step forward: It demonstrates interest from Republicans, ensuring that PBM oversight is, as it should be, a bipartisan issue.
- Federal Trade Commission inquiry: The FTC announced it would conduct an inquiry into the competitive impact of contracting and other PBM business practices, including the impact on access to and affordability of prescription drug. The agency will review how PBMs negotiate rebates and fees with drug manufacturers, create drug formularies and policies and reimburse pharmacies for patients’ prescriptions. Again, this will take time, and the PBMs will ask for extensions. But it’s an important beginning. Once the FTC receives the requested documents, we will begin to have a better understanding of how the industry works.
I see at least two important takeaways from these developments. First, we see that concerted advocacy works. Second, we’re seeing bipartisan demands for transparency.
Why our partnership matters
ERIC represents roughly 100 of the largest employers in the country—employers who sponsor employee benefit plans for their nationwide workforces, their families and often retirees as well. Our members spend hundreds of billions—billions—of dollars on health care, but we don’t always get great value for the money spent. The patients we cover don’t always receive optimal care. GTMRx focuses on improving that care in ways that enhance patient health and save money. There is a confluence of interests. We can work together to advance reforms that lead to better health and financial outcomes—reforms that lead to better care and less waste.
GTMRx has policy and health care delivery expertise. ERIC has direct relationships with employers and extensive government affairs expertise. We know how to change laws.
Together, we can develop great solutions and see them implemented.