Industry advocates, including ACR, file argument backing North Dakota's regulation of Pharmacy Benefit Manager industry
In a significant development, the Supreme Court has vacated a decision made by the 8th Circuit Court of Appeals in the case of PCMA v. Wehbi and remanded it back to the court with instructions to reconsider in light of the decision made in Rutledge v. PCMA.
The PCMA v. Wehbi case was initially ruled in favour of PCMA by the 8th Circuit Court of Appeals. However, the Supreme Court's decision to vacate this ruling and remand it back for reconsideration has sparked renewed interest.
The Rutledge case, decided by the Supreme Court in December 2020, established that state regulations that might impact costs in ERISA plans do not violate the preemption clause. This decision has opened the door for states to exercise regulatory power over pharmacy benefit managers (PBMs).
In response to this, the Alliance for Transparent & Affordable Prescriptions (ATAP), Community Oncology Alliance (COA), American Pharmacies, and the American College of Rheumatology (ACR) have filed an amicus brief with the 8th Circuit Court of Appeals in support of North Dakota's regulations on PBMs.
The amicus brief addresses the role of PBMs in the drug supply chain and the egregious nature of some PBM practices. It explains that states can exercise regulatory power to curb PBM practices following the U.S. Supreme Court's decision in Rutledge v. PCMA.
The ACR, a not-for-profit organization serving over 7,700 physicians, health professionals, and scientists worldwide, is represented on ATAP's Executive Committee by Dr. Angus Worthing, a practicing rheumatologist. Dr. Worthing stated that the brief aims to support North Dakota's arguments and preserve legislation that curbs PBM practices.
North Dakota's legislation includes banning gag clause provisions that restrict what pharmacists can tell patients and preventing PBMs from charging a copay that is more than the cost of the drug—a practice known as spread pricing.
A ruling on the case is not expected until the Spring of 2022. The full amicus brief can be read in its entirety here.
The ACR's mission includes offering education, research, advocacy, and practice management support to its members. However, there is no specific information available about the representatives of the American College of Rheumatology in ATAP and COA regarding their involvement in supporting North Dakota's efforts to regulate PBMs.
Stay tuned for updates on this important case and the potential impact it may have on the pharmaceutical industry.
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