PBM INDUSTRY REGULATION TO BE ARGUED BY SUPREME COURT Patient Advocate Groups Optimistic Courts Will Support State Rights to Regulate



As policy makers in Washington, DC debate the next appointee to the United States Supreme Court, patient advocate groups are optimistic existing Justices and the nominee will support rights of states to impose regulations on the Pharmacy Benefit Manager (PBM) industry. The case, Rutledge v. the Pharmaceutical Care Management Association, will argued before the Supreme Court on October 6, 2020. The Alliance for Transparent and Affordable Prescriptions (ATAP), a coalition of patient and provider groups concerned about the role PBMs play in the rising cost of drugs and reduced patient access to affordable treatment, filed an Amicus Brief with the United States Supreme Court in an effort to support the rights of states to impose regulations on the PBM industry.



ATAP’s Amicus Brief argues in part that PBMs are engaged in abusive practices with serious practical and policy consequences – including upward pressure on prescription drug pricing.



“The relationship that really matters is the doctor-patient relationship, not the relationship with the middlemen” stated Dr. Robert Levin, ATAP’s President. “Every day, we witness first-hand how the PBM industry drives up costs and interferes with patient access to the medications they need. Doctors, patients, and legislators are saying ‘enough is enough’ and are fighting back. We welcome the opportunity to lend our voice and arguments on behalf of patients as the Supreme Court weighs in on regulating this industry.”



The debate over the PBM industry is gaining traction in Washington as additional regulations are proposed, and even Presidential Executive Orders crafted in part to reign in PBM activity in the prescription drug marketplace.



“PBMs construct formularies and utilization management tools not based on science but on profit, often leading to higher drug prices,” Dr. Madeline Feldman of the Coalition of State Rheumatology Organizations (an ATAP member organization) stated. “The Supreme Court should agree to allow states to protect ALL patients from the machinations of PBMs – whose only fiduciary responsibility is to shareholders. Perhaps if the federal government demanded transparency and regulated PBMs appropriately, the states wouldn’t have to step up to do the job.”



"Countless healthcare stakeholders have waited eagerly for this day to come and will be closely watching the proceedings since this is the first case involving a PBM before the United States Supreme Court," stated Kathleen A. Arntsen, President & CEO of Lupus and Allied Diseases Association (an ATAP member organization). "As a patient-led organization who represents people that deal with serious health conditions on a daily basis, we have firsthand experience with the frustration in struggling to access affordable and appropriate treatments due to the existence of the unnecessary middleman industry. We are thrilled that the Justices will finally weigh in on these momentous issues and hopeful that they will stand with patients and rule in favor of fair drug pricing."



In an earlier statement on the matter, the plaintiff, Arkansas Attorney General Leslie Rutledge stated, “Our fight to protect Arkansans’ access to affordable prescription drugs will finally have its day before the Supreme Court. With arguments to be aired live, Americans will hear how we are protecting local pharmacists who play the vital role as frontline healthcare providers in rural Arkansas and across the country every day and particularly during this pandemic.”



ATAP has been an active advocate for patients in a variety of federal and state battles to amplify the voices of patients and physicians.



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For more information, or to schedule an interview with an ATAP spokesperson please contact Dan Rene at 202-329-8357.