The Push for Healthcare Price Transparency: Will Pharmacies See a Benefit?

Jason Murry, Senior Director, Healthcare Sales | January 10, 2024


Recent passage of the Lower Costs, More Transparency (LCMT) Act in a bipartisan vote by the U.S. House of Representatives is being heralded by the bill’s sponsors as “landmark legislation,” but is it really? The bill -- which is a long way from becoming law -- is focused on the very politically popular issue of lowering prescription drug prices for consumers. But where is the benefit for pharmacies?
The Energy and Commerce Committee website provides an overview of the Act that is notably absent of any meaningful reference to pharmacies and the support they need to effectively contend with current pharmacy benefit manager (PBM) practices, more efficiently serve patients and operate with the profitability they need to remain in business.

And a closer look into the bill itself doesn’t do anything to instill confidence that Congress recognizes the additional responsibility it has to protect and facilitate the providers who are the face of prescription medication to America’s increasingly burdened patient population. As an example, the bill requires that PBMs provide employer health plans with detailed data on prescription drug spending; so there’s arguably better reporting “up.” But what about greater, seriously needed information sharing with pharmacy providers?

While the bill does ban PBMs from using spread pricing -- and instead receive an administrative fee --  it does so relative only to PBMs contracting with Medicaid managed care organizations. It’s a start, but far from sufficient to meaningfully impact pharmacy business health in the long term.

Achieving greater price transparency in healthcare will bring benefits to patients but any legislation pointed at improving the economics of our industry must also point directly at pharmacies. Until that happens, pharmacy operators need to look for a partner to help them maximize transparency and protect profitability. And that’s a great place for us to start a conversation.


Contributions by Greg Brownstein, Inmar Healthcare

Jason Murry, Senior Director, Healthcare Sales