James Comer, Chairman of the United States House Committee on Oversight and Accountability, called on CEOs of three pharmacy benefit managers (PBMs) to correct the record for statements made during their appearances at a recent House Oversight Committee hearing. The three executives – of CVS Caremark, Express Scripts, and OptumRx – testified during a July 23, 2024, hearing, “The Role of Pharmacy Benefit Managers in Prescription Drug Markets Part III: Transparency and Accountability.”
While present at the hearing, the executives made statements that contradict findings by the House Committee and the Federal Trade Commission about PBMs’ “self-benefitting practices that jeopardize patient care, undermine local pharmacies, and raise prescription drug prices.” For example, in the hearing, the executives for all three PBMs stated that they do not steer patients to pharmacies owned by the PBMs. Additionally, they made claims that stand in contrast to findings by the Committee and the FTC regarding contract negotiations, contract opt outs, and payments to pharmacies.
The letters sent to the three executives cite to several exchanges throughout the hearing, with hearing transcripts included in the letter. One such exchange discusses the steering issue, with all three executives saying their companies do not steer patients to affiliated pharmacies, which contradicts the FTC report that says, “PBMs routinely create narrow and preferred pharmacy networks that can advantage their own pharmacies while excluding rivals.”
Another exchange, cited in the letter to Adam Kautzner, PhD, President of Express Scripts, is between Congressman Fry and Dr. Kautzner, where Dr. Kautzner testified that pharmacies are able to negotiate with PBMs by redlining a contract and negotiating that way. However, Comer notes that the FTC found that Express Scripts – as well as Optum Rx and CVS Caremark – do not allow non-affiliated pharmacies to redline and negotiate contracts. Comer also notes that the Committee received evidence from multiple pharmacies who attempted to negotiate contracts with redlining who were unsuccessful, being told by Express Scripts that the “rates are non-negotiable.”
The letters written to the three executives states, “The Committee highlights 18 U.S.C. § 1001, which states, ‘in any matter within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, knowingly and willfully–…(2) makes any materially false, fictitious, or fraudulent statement or representation;…shall be fined under this title, imprisoned not more than 5 years.’ The Committee also highlights 18 U.S.C. § 1621, which states, ‘having taken an oath before a competent tribunal, officer, or person, in any case in which a law of the United States authorizes an oath to be administered, that he will testify, declare, depose or certify truly, or that any written testimony, declaration, deposition, or certificate by him subscribed, is true, willfully and contrary to such oath states or subscribes any material matter which he does not believe to be true…is guilty of perjury and shall…be fined under this title or imprisoned not more than five years, or both.’ Please provide any necessary corrections to the record prior to September 11, 2024.”